Vagus nerve stimulation lowers costs of care for children with uncontrolled epilepsy —

Vagus nerve stimulation (VNS), generally known as a “pacemaker for the mind,” includes a stimulator machine that’s implanted below the pores and skin within the chest, with a wire that’s wound across the vagus nerve within the neck. It helps stop seizures by sending common, delicate electrical pulses to the mind. Usually, the affected person shouldn’t be conscious the machine is working.

A brand new research from Ann & Robert H. Lurie Youngsters’s Hospital of Chicago revealed within the journal Epilepsiaexamined a inhabitants of pediatric sufferers with drug-resistant epilepsy. For these sufferers, the research discovered that the sufferers who obtained VNS, when used with anti-seizure drugs (ASM), had decrease hospital prices in comparison with using ASM alone. The research discovered that the sufferers handled with ASM plus VNS had financial savings of over $3,000 of epilepsy-related annual prices per 12 months, in comparison with remedy with ASM solely. These findings mirror the workforce’s earlier report of kids with drug-resistant epilepsy having considerably decreased inpatient healthcare utilization following VNS plus ASM in comparison with these handled with ASM alone. The research on healthcare utilization was revealed in Epilepsy & Conduct.

“We take a well being providers analysis perspective on the sufferers’ journey with a difficult illness means of drug-resistant epilepsy that has not been met with a treatment. For sufferers with drug-resistant epilepsy, lowering seizure burden and addressing high quality of life are vital objectives. We quantify features of outcomes of surgical therapies and medical therapies, and we assess the impression on well being care prices and utilization. To the sufferers, households, well being care methods, well being care advocates, and policymakers, these are vital outcomes,” mentioned senior writer Sandi Lam, MD, MBA, Division Head of Neurosurgery at Lurie Youngsters’s and Professor of Neurological Surgical procedure at Northwestern College Feinberg College of Medication. “Whereas we present decrease prices to the well being care system following VNS surgical procedure, from a sensible standpoint it means fewer hospital admissions due to seizures. Sufferers spend their days at house as an alternative of within the hospital.”

The research is exclusive in a number of methods. There was no earlier analysis specializing in kids with drug-resistant epilepsy and evaluating the outcomes of those that had VNS and ASMs and people who solely obtained ASMs. The research additionally gives a breakdown of prices by web site of care (inpatient, outpatient, and Emergency Division). The research researchers discovered that emergency division prices decreased extra for youngsters handled with VNS and ASM, in comparison with ASM alone. Whereas common annual whole prices had been increased within the ASM-only cohort, the researchers additionally noticed that outpatient care prices for VNS with ASM had been increased than ASM alone. The research authors be aware that it isn’t shocking that kids required extra outpatient care shortly after VNS implantation, since machine adjustment for every affected person is important on this time interval. Outpatient prices for youngsters with VNS decreased dramatically within the second 12 months. Future research warrant extra give attention to prices and patterns of care in long term follow-up.

Analysis with nationwide information don’t substitute for scientific analysis. Every affected person with epilepsy presents a singular case requiring tailor-made scientific care that needs to be managed at a complete Degree 4 NAEC pediatric epilepsy heart like Lurie Youngsters’s. Giant research with well being providers analysis can inform future analysis in addition to gaps and alternatives in well being care supply. The research exhibits that surgical choices needs to be part of the epilepsy remedy armamentarium. Whereas future research will take a look at cranial epilepsy surgical procedure outcomes, this research was restricted to VNS and didn’t embrace epilepsy surgical procedure on the mind, which is a crucial approach of epilepsy remedy.

The research included kids (0-17 years of age) who had been identified with refractory epilepsy, with 1113 sufferers handled with ASM plus VNS and 3471 sufferers handled with ASM solely. Information had been sourced from the Youngsters’s Hospital Affiliation’s Pediatric Well being Info System (PHIS) database, which comprises inpatient, emergency division, ambulatory, and remark encounter degree information from greater than 44 kids’s hospitals in america. Sufferers within the research had been adopted one 12 months prior and two years after assembly pre-determined standards for refractory epilepsy.

Analysis at Ann & Robert H. Lurie Youngsters’s Hospital of Chicago is performed by way of the Stanley Manne Youngsters’s Analysis Institute. The Manne Analysis Institute is targeted on bettering little one well being, remodeling pediatric drugs and guaranteeing more healthy futures by way of the relentless pursuit of information. Lurie Youngsters’s is ranked as one of many nation’s prime kids’s hospitals by U.S. Information & World Report. It’s the pediatric coaching floor for Northwestern College Feinberg College of Medication.

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