New Onset (Incidence) of Epilepsy and Seizures in Nursing Home Residents.
New Onset (Incidence) of Epilepsy and Seizures in Nursing Home Residents.
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DOI：
10.1016/j.jamda.2022.06.001
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发表时间：
2022-09
影响因子：
7.6
通讯作者：
Eberly, Lynn E.
中科院分区：
文献类型：
--
作者：
Leppik, Ilo E.;Birnbaum, Angela K.;Svensden, Kenneth;Eberly, Lynn E.
The point prevalence of epilepsy is high in nursing homes (NH), but the incidence of epilepsy after admission is unknown. This study was done to determine the incidence of epilepsy/seizure (epi/sz) co-morbid with other conditions in elderly NH residents. Retrospective evaluation of Minimum Data Set (MDS) records to identify new onset epi/sz in NH residents. Five cross-sectional cohorts of all residents in any Medicare/Medicaid certified NH in the United States on July 15 of each year 2003–2007. Epi/sz was identified by ICD-9 codes (345.xx or 780.39) or check box on the MDS. Those with no such code on admission and with one to three plus years of follow up (n=3,609,422) were followed through 2007 or end of stay. Overall incidence of epi/sz was 16.42 /1000 patient years (PY). Incidence was highest in the first year after admission and declined thereafter. There were more women (n=2,523,951) than men (n=1,089,631), but men had a higher incidence (21.17/1000PY) compared to women (14.81/1000PY). Although the 65–74 cohort included fewer residents (n=594,722) compared to the 85+ cohort (n=1,520,167), the younger residents had the highest incidence (28.53/1000PY) compared to the oldest, 10.22/1000PY for the 85+ cohort. The highest incidences were among those with brain tumor (122.55/1000PY), followed by head injury (45.66/1000PY). Overall, 714,340 had a diagnosis of stroke, and incidence was 27.52/1000PY. Those with none of selected risk factors had an overall incidence of 12.45/1000PY. The incidence of epi/sz in elderly after admission to a NH is high. There is a need to develop practice approaches to best manage this large cohort. There does not appear to be a uniform approach to managing new onset epilepsy in NHs at this time. Studies to develop evidence for practice guidelines are needed. The overall incidence of epi/sz was 16.42/1000 patient years (PY) in 3,609,422 patients aged 65+ years followed for 3+ years in US nursing homes. New onset epilepsy is common in nursing homes and much higher than in community dwelling elderly.
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影响因子：
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通讯作者：
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