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. 2022;27(1):29-37.
doi: 10.5863/1551-6776-27.1.29. Epub 2021 Dec 22.

Trends and Costs Associated With the Diagnosis and Treatment of Infantile Spasms: A 10-Year Multicenter Retrospective Review

Mindl M Weingarten  1 , Jon A Cokley  2 , Brady Moffett  2 , Shannon DiCarlo  2 , Sunita N Misra  3
Affiliations

Trends and Costs Associated With the Diagnosis and Treatment of Infantile Spasms: A 10-Year Multicenter Retrospective Review

Mindl M Weingarten et al. J Pediatr Pharmacol Ther. 2022.

Abstract

Objective: Early treatment of infantile spasms (IS) may be imperative for improvement of neurodevelopmental outcomes. Existing studies have led to inconclusive recommendations with variation in treatment. Our objective was to determine the national average cost, initial diagnostic workup, treatments, and hospital length of stay for patients with IS.

Methods: This retrospective cohort study was designed to review data of patients < 2 years from 43 non-profit institutions. Data obtained included patient demographics, length of stay, admission cost, and treatments used from 2004 to 2014. Cost data were collected and adjusted to 2014 dollars, the year data were analyzed.

Results: A total of 6183 patients met study criteria (n = 3382, 55% male). Three-quarters of patients (n = 4684, 76%) had an electroencephalogram, 56.4% had brain imaging (n = 3487), and 17% (n = 1050) underwent a lumbar puncture. Medication for IS was initiated during inpatient hospital stay in two-thirds of all patients (n = 4139, 67%). Most patients were initiated on corticotropin (n = 2066, 33%) or topiramate (n = 1804, 29%). Average length of stay was 5.8 days with an average adjusted cost of $18,348. Over time there was an 86.6% increase in cost from an average $12,534.54 (2004) to $23,391.20 (2014), a significant change (p < 0.01). This correlated with an increase in average length of stay.

Conclusions: Variability exists in diagnostic workup and pharmacotherapy initiated for IS, which may lead to differences in the cost of hospital stay. Further studies may help determine contributing factors to increased cost and improve health care utilization for IS patients.

Keywords: West syndrome; adrenocorticotropic hormone; epileptic spasms; epileptic syndrome; infantile spasms; pharmacoeconomics; vigabatrin.

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Conflict of interest statement

Disclosures. None of the authors has any conflict of interest to disclose. Financial interests include consulting fees from Tim Peters and Company, Inc. The authors had full access to all data and take responsibility for the integrity and accuracy of the data analysis.

Figures

Figure 1.
Figure 1.
Average electroencephalogram trends.
Figure 2.
Figure 2.
Average microarray trends.
Figure 3.
Figure 3.
Hormone therapy trends.
Figure 4.
Figure 4.
Average length of stay trends.
See this image and copyright information in PMC

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