Abstract
Objective
MR-guided laser interstitial thermal therapy (LITT) is increasingly used for refractory epilepsy. The goal of this investigation is to directly compare cost and short-term adverse outcomes for adult refractory epilepsy treated with temporal lobectomy and LITT, as well as identify risk factors for increased costs and adverse outcomes.
Methods
The National Inpatient Sample (NIS) was queried for patients who received LITT between 2012-2019. Patients with adult refractory epilepsy were identified. Multivariable mixed effects models were used to analyze predictors of cost, length of stay (LOS), and complications.
Results
LITT was associated with reduced LOS and overall cost relative to temporal lobectomy, with a statistical trend towards lower incidence of postoperative complications. High-volume surgical epilepsy centers had lower LOS overall. Longer LOS was a significant driver of increased cost for LITT, and higher comorbidity index was associated with nonroutine discharge.
Significance
LITT is an affordable alternative to temporal lobectomy for adult refractory epilepsy with an insignificant reduction in inpatient complications. Patients may benefit from expanded access to this treatment modality for both its reduced LOS and lower cost.
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