title: In-hospital costs in patients with seizures and epilepsy after stroke.
abstract: OBJECTIVE
  To verify the net effect of seizures after stroke on the use of in-hospital health care resources.
  
  
  METHODS
  Consecutive patients with first-ever stroke were admitted to the stroke unit of a Moscow hospital and followed prospectively until death or discharge. Each patient experiencing seizures was matched for age, sex, stroke type, National Institutes of Health Stroke Scale score at admission, and stroke risk factors to 2+ patients with no seizures, as controls. Resources consumed included length of hospital stay, admission to the intensive care unit (ICU), diagnostic tests, medical consultations and treatments. Cost estimates were based on the Russian National Health Service perspective.
  
  
  RESULTS
  The sample comprised 30 patients with in-hospital seizures and 70 matched controls. Patients dying in hospital were 15 of 30 (50%) versus 4 of 70 (5.7%) (p < 0.001). The overall cost of hospital stay was only slightly (nonsignificantly) higher in patients with seizures, but the cost was significantly higher in patients who died than in patients who were discharged alive. Compared to the controls, patients with seizures spent more intensive care unit (ICU) days and required more computed tomography (CT) scans, x-rays, endoscopies, and specialist consultations, causing higher in-hospital costs.
  
  
  CONCLUSIONS
  In patients with first-ever stroke, seizures per se do not increase the overall in-hospital costs. However, the higher than expected mortality in patients with seizures is associated with additional hospital costs.
authors.affiliation: Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russian Federation.|Department of Neurology, Neurosurgery and Genetics, Russian National Research Medical University, Moscow, Russian Federation.|Moscow City Hospital No. 12, Moscow, Russian Federation.
authors.forename: Alla
authors.initials: A
authors.lastname: Guekht
authors.affiliation: Department of Neurology, Neurosurgery and Genetics, Russian National Research Medical University, Moscow, Russian Federation.|Moscow City Hospital No. 12, Moscow, Russian Federation.
authors.forename: Maria
authors.initials: M
authors.lastname: Mizinova
authors.affiliation: Department of Neurology, Neurosurgery and Genetics, Russian National Research Medical University, Moscow, Russian Federation.|Moscow City Hospital No. 12, Moscow, Russian Federation.
authors.forename: Andrey
authors.initials: A
authors.lastname: Ershov
authors.affiliation: Department of Neurology, Neurosurgery and Genetics, Russian National Research Medical University, Moscow, Russian Federation.|Moscow City Hospital No. 12, Moscow, Russian Federation.
authors.forename: Denis
authors.initials: D
authors.lastname: Guz
authors.affiliation: Department of Neurology, Neurosurgery and Genetics, Russian National Research Medical University, Moscow, Russian Federation.|Moscow City Hospital No. 12, Moscow, Russian Federation.
authors.forename: Igor
authors.initials: I
authors.lastname: Kaimovsky
authors.affiliation: IRCCS "Mario Negri" Institute for Pharmacological Research, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Messina
authors.affiliation: IRCCS "Mario Negri" Institute for Pharmacological Research, Milan, Italy.
authors.forename: Ettore
authors.initials: E
authors.lastname: Beghi
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D003422:Critical Care / Q000191:economics; D004827:Epilepsy / Q000175:diagnosis / Q000191:economics / Q000209:etiology; D005260:Female; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D009031:Moscow; D012017:Referral and Consultation / Q000191:economics; D012640:Seizures / Q000175:diagnosis / Q000191:economics* / Q000209:etiology; D020521:Stroke / Q000150:complications / Q000175:diagnosis / Q000191:economics*; D014057:Tomography, X-Ray Computed / Q000191:economics
keywords: Direct costs; Epilepsy; Russia; Seizures; Stroke; Treatment