title: Tuberous Sclerosis Health Care Utilization Based on the National Inpatient Sample Database: A Review of 5655 Hospitalizations.
abstract: BACKGROUND
  Tuberous sclerosis complex (TSC) has an incidence of 1/6000 in the general population. Overall care may be complex and costly. We examine trends in health care utilization and outcomes of patients with TSC over the last decade.
  
  
  METHODS
  The National Inpatient Sample (NIS) database for inpatient hospitalizations was searched for admission of patients with TSC.
  
  
  RESULTS
  During 2000-2010, the NIS recorded 5655 patients with TSC. Most patients were admitted to teaching hospitals (71.7%). Over time, the percentage of craniotomies performed per year remained stable (P = 0.351). Relevant diagnoses included neuro-oncologic disease (5.4%), hydrocephalus (6.5%), and epilepsy (41.2%). Hydrocephalus significantly increased length of stay and hospital charges. A higher percentage of patients who underwent craniotomy had hydrocephalus (29.8% vs. 5.3%; P < 0.001), neuro-oncologic disease (43.5% vs. 3.4%; P < 0.001), other cranial diseases (4.2% vs. 1.2%; P < 0.001), and epilepsy (61.4% vs. 40.1%; P < 0.001).
  
  
  CONCLUSIONS
  Our study identifies aspects of inpatient health care utilization, outcomes, and cost of a large number of patients with TSC. These aspects include related diagnoses and procedures that contribute to longer length of stay, increased hospital cost, and increased in-hospital mortality, which can inform strategies to reduce costs and improve care of patients with TSC.
authors.affiliation: Department of Neurosurgery, New York University, New York, New York, USA. Electronic address: agarwaln@upmc.edu.
authors.forename: Taylor A
authors.initials: TA
authors.lastname: Wilson
authors.affiliation: Department of Neurosurgery, New York University, New York, New York, USA.
authors.forename: Shaun
authors.initials: S
authors.lastname: Rodgers
authors.affiliation: Department of Neurosurgery, New York University, New York, New York, USA.
authors.forename: Omar
authors.initials: O
authors.lastname: Tanweer
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Prateek
authors.initials: P
authors.lastname: Agarwal
authors.affiliation: Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
authors.forename: Bryan A
authors.initials: BA
authors.lastname: Lieber
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Nitin
authors.initials: N
authors.lastname: Agarwal
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: McDowell
authors.affiliation: Department of Neurosurgery, New York University, New York, New York, USA; Division of Epilepsy, Department of Neurology, New York University, New York, New York, USA.
authors.forename: Orrin
authors.initials: O
authors.lastname: Devinsky
authors.affiliation: Department of Neurosurgery, New York University, New York, New York, USA.
authors.forename: Howard
authors.initials: H
authors.lastname: Weiner
authors.affiliation: Department of Neurosurgery, New York University, New York, New York, USA.
authors.forename: David H
authors.initials: DH
authors.lastname: Harter
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003399:Craniotomy / Q000191:economics / Q000706:statistics & numerical data*; D004827:Epilepsy / Q000191:economics / Q000628:therapy*; D005260:Female; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D006849:Hydrocephalus / Q000191:economics / Q000628:therapy*; D007223:Infant; D008297:Male; D009423:Nervous System Neoplasms / Q000191:economics / Q000628:therapy*; D017063:Outcome Assessment, Health Care / Q000191:economics / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014402:Tuberous Sclerosis / Q000191:economics / Q000628:therapy*; D055815:Young Adult
keywords: Epilepsy; Health care utilization; Hydrocephalus; National Inpatient Sample; Neurosurgical care; Subependymal giant cell astrocytoma; Tuberous sclerosis complex