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Peer-reviewedCC BYEuropean journal of neurology

Prospective, Population-Based Evaluation of Costs and Outcomes of Status Epilepticus According to the New Definition.

  • Clara Jünemann1
  • Meike Menche1
  • Jens-Peter Reese2,3
  • Felix Rosenow4
  • Martin Jünemann5
  • Christoph Best6
  • Michael Teepker7
  • Christian Roth8,9
  • Ingrid Sünkeler10
  • Elisabeth Pryss11
  • Leona Möller1
  • Katja Menzler1
3 more authors
  • Lars Timmermann1
  • Susanne Knake1
  • Adam Strzelczyk1,4,12
12 affiliations
  1. 1Epilepsy Center Hessen, Philipps University, Marburg, Germany.
  2. 2Center for Epidemiology and Biometry, Julius Maximilians University, Würzburg, Germany.
  3. 3Public Health and Epidemiology, Health Services Research, and Health Data Science, Technische Hochschule Mittelhessen, Giessen, Germany.
  4. 4Epilepsy Center Frankfurt Rhine-Main, Goethe University, Frankfurt am Main, Germany.
  5. 5Clinic for Neurology, Justus Liebig University, Gießen, Germany.
  6. 6Vitos Clinic for Neurology, Weilmünster, Germany.
  7. 7Hardtwald Clinic I for Neurology, Bad Zwesten, Germany.
  8. 8Department of Neurology, Klinikum Kassel, Kassel, Germany.
  9. 9DRK Kliniken Nordhessen, Kassel, Germany.
  10. 10BDH Clinic for Neurology, Braunfels, Germany.
  11. 11Clinic for Internal Medicine, Frankenberg, Germany.
  12. 12Section Epileptology, Department of Neurology, Jena University Hospital, Jena, Germany.
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Abstract

Background

To address the paucity of data on outcomes and costs of status epilepticus (SE) following the updated 2015 International League Against Epilepsy (ILAE) definition and changes in clinical practice guidelines in Germany.Methods

This prospective population-based study (October 2018-March 2020) included adult patients from postal code area prefix 35, representative of Germany, diagnosed with SE according to the 2015 ILAE definition. Costs were calculated using German Diagnosis-Related Groups (G-DRG).Results

In total, 181 patients were included. Mean inpatient costs were €10,543 (median €6376; range €845-€133,267), corresponding to €939 per hospital day (median €580.8; range €76.8-€12,115). Mean length of stay (LOS) was 11 days (median 9; range 1-67). In univariable analyses, super-refractory SE was associated with higher costs and longer LOS (both p < 0.001), while acute symptomatic etiology was associated with longer LOS (p = 0.006). On multivariable analysis, mechanical ventilation was the strongest independent predictor of costs (Exp(B) = 2.918, 95% CI 1.753-4.857; p < 0.001), and etiology was overall significantly associated with cost variation (p = 0.022), with acute symptomatic SE showing the highest adjusted costs. Discharge destination correlated with SE severity, with most patients with non-refractory SE discharged home (p = 0.028).Conclusions

This study provides population-based data on costs and outcomes of SE in Germany, serving as a basis for future cost-effectiveness analyses. Compared with earlier studies, lower direct costs and shorter LOS were observed. Identification of high-risk constellations may support clinical decision-making and optimize monitoring, treatment escalation, and allocation of intensive care resources.

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Cite

BibTeXRIS
BibTeX
@article{junemann2026prospective,
  title = {{Prospective, Population-Based Evaluation of Costs and Outcomes of Status Epilepticus According to the New Definition.}},
  author = {Clara Jünemann and Meike Menche and Jens-Peter Reese and Felix Rosenow and Martin Jünemann and Christoph Best and Michael Teepker and Christian Roth and Ingrid Sünkeler and Elisabeth Pryss and Leona Möller and Katja Menzler and Lars Timmermann and Susanne Knake and Adam Strzelczyk},
  journal = {European journal of neurology},
  year = {2026},
  month = oct,
  doi = {10.1111/ene.70777},
  url = {https://europepmc.org/article/MED/42899468},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Prospective, Population-Based Evaluation of Costs and Outcomes of Status Epilepticus According to the New Definition.
AU  - Clara Jünemann
AU  - Meike Menche
AU  - Jens-Peter Reese
AU  - Felix Rosenow
AU  - Martin Jünemann
AU  - Christoph Best
AU  - Michael Teepker
AU  - Christian Roth
AU  - Ingrid Sünkeler
AU  - Elisabeth Pryss
AU  - Leona Möller
AU  - Katja Menzler
AU  - Lars Timmermann
AU  - Susanne Knake
AU  - Adam Strzelczyk
PY  - 2026
DA  - 2026/10/01
JO  - European journal of neurology
DO  - 10.1111/ene.70777
UR  - https://europepmc.org/article/MED/42899468
AB  - Background  To address the paucity of data on outcomes and costs of status epilepticus (SE) following the updated 2015 International League Against Epilepsy (ILAE) definition and changes in clinical practice guidelines in Germany.Methods  This prospective population-based study (October 2018-March 2020) included adult patients from postal code area prefix 35, representative of Germany, diagnosed with SE according to the 2015 ILAE definition. Costs were calculated using German Diagnosis-Related Groups (G-DRG).Results  In total, 181 patients were included. Mean inpatient costs were €10,543 (median €6376; range €845-€133,267), corresponding to €939 per hospital day (median €580.8; range €76.8-€12,115). Mean length of stay (LOS) was 11 days (median 9; range 1-67). In univariable analyses, super-refractory SE was associated with higher costs and longer LOS (both p < 0.001), while acute symptomatic etiology was associated with longer LOS (p = 0.006). On multivariable analysis, mechanical ventilation was the strongest independent predictor of costs (Exp(B) = 2.918, 95% CI 1.753-4.857; p < 0.001), and etiology was overall significantly associated with cost variation (p = 0.022), with acute symptomatic SE showing the highest adjusted costs. Discharge destination correlated with SE severity, with most patients with non-refractory SE discharged home (p = 0.028).Conclusions  This study provides population-based data on costs and outcomes of SE in Germany, serving as a basis for future cost-effectiveness analyses. Compared with earlier studies, lower direct costs and shorter LOS were observed. Identification of high-risk constellations may support clinical decision-making and optimize monitoring, treatment escalation, and allocation of intensive care resources.
SN  - 1351-5101
SN  - 1468-1331
ER  -