1. Role of comorbidities in epilepsy surgery outcomes of older adults.
- Author
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Tsai, Carolyn, Taylor, Sara, Thompson, Nicolas, Vegh, Deborah, Bingaman, William, Jehi, Lara, and Punia, Vineet
- Abstract
We lack knowledge about prognostic factors of resective epilepsy surgery (RES) in older adults (≥60 years), especially the role of comorbidities, which are a major consideration in managing the care of people with epilepsy (PWE). We analyzed a single‐center cohort of 94 older adults (median age = 63.5 years, 52% females) who underwent RES between 2000 and 2021 with at least 6 months of postsurgical follow‐up. Three fourths of the study cohort had lesional magnetic resonance imaging and underwent temporal lobectomy. Fifty‐four (57%) PWE remained seizure‐free during a median follow‐up of 3.5 years. Cox proportional hazard multivariable analysis showed that aura (hazard ratio [HR] = .52, 95% confidence interval [CI] = .27–1.00), single ictal electroencephalographic pattern (HR = .33, 95% CI = .17–.660), and Elixhauser Comorbidity Index (HR = 1.05, 95% CI = 1.00–1.10) were independently associated with seizure recurrence at last follow‐up. A sensitivity analysis using the Charlson Combined Score (HR = 1.38, 95% CI = 1.03–1.84, p = .027) confirmed the association of comorbidities with worse seizure outcome. Our findings provide a framework for a better informed discussion about RES prognosis in older adults. More extensive, multicenter cohort studies are needed to validate our findings and reduce hesitancy in pursuing RES in suitable older adults. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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