Trends in the Utilization of Surgical Modalities for the Treatment of Drug-Resistant Epilepsy: A Comprehensive 10-Year Analysis Using the National Inpatient Sample

作者：Abdul Karim Ghaith, Victor Gabriel El-Hajj, Jesús E. Sánchez-Garavito, Cameron Zamanian, Marc Ghanem, Antonio Bon‐Nieves, Baibing Chen, Cornelia Drees, David A. Miller, Jonathon J. Parker, João Paulo Almeida, Adrian Elmi‐Terander, William O. Tatum, Erik H. Middlebrooks, Mohamad Bydon, Jamie J. Van Gompel, Brian N. Lundstrom, Sanjeet S. Grewal · 发表于：Neurosurgery · 年份：2024 · DOI：10.1227/neu.0000000000002811 · 被引用次数：11 · 研究领域：Vagus Nerve Stimulation Research、Neurological disorders and treatments、Epilepsy research and treatment

BACKGROUND AND OBJECTIVES: Epilepsy is considered one of the most prevalent and severe chronic neurological disorders worldwide. Our study aims to analyze the national trends in different treatment modalities for individuals with drug-resistant epilepsy and investigate the outcomes associated with these procedural trends in the United States. METHODS: Using the National Inpatient Sample database from 2010 to 2020, patients with drug-resistant focal epilepsy who underwent laser interstitial thermal therapy (LITT), open surgical resection, vagus nerve stimulation (VNS), or responsive neurostimulation (RNS) were identified. Trend analysis was performed using piecewise joinpoint regression. Propensity score matching was used to compare outcomes between 10 years prepandemic before 2020 and the first peak of the COVID-19 pandemic. RESULTS: This study analyzed a total of 33 969 patients with a diagnosis of drug-resistant epilepsy, with 3343 patients receiving surgical resection (78%), VNS (8.21%), RNS (8%), and LITT (6%). Between 2010 and 2020, there was an increase in the use of invasive electroencephalography monitoring for seizure zone localization ( P = .003). There was an increase in the use of LITT and RNS ( P < .001), while the use of surgical resection and VNS decreased over time ( P < .001). Most of these patients (89%) were treated during the pre-COVID pandemic era (2010-2019), while a minority (11%) underwent treatment during the COVID pandemic (2020). After propensity sc...