Frequency of takotsubo cardiomyopathy in epilepsy-related hospitalizations among adults and its impact on in-hospital outcomes: A national standpoint

Abstract Background Literature remains constrained to case reports with respect to epilepsy-associated takotsubo cardiomyopathy (TC) or stress-induced cardiomyopathy and its impact on in-hospital outcomes remains largely obscure. Methods The National Inpatient Sample databases (2010–2014) were queried to identify and compare baseline characteristics and outcomes in adult hospitalizations for epilepsy with and without secondary TC using ICD-9-CM codes and propensity-matching. Primary outcomes were the frequency of TC, ensuing all-cause mortality, and complications. Secondary outcome was healthcare resource utilization. Results Of 981,571 epilepsy-related hospitalizations, 854 (0.1%, 1 in 1000) admissions (unspecified, 49.1%; grand mal/status epilepticus, 28.1% and generalized convulsive 11.7%) revealed associated in-hospital TC. Of the propensity-matched cohorts of epilepsy (TC = 793; mean 61.1 ± 15.0 yrs. & 82.4% females vs. non-TC = 795; mean 60.7 ± 14.2 yrs. & 84.2% females), the TC group consisted more often white (83.7% vs. 78.0%, p p  = 0.002), arrhythmia (22.7% vs. 18.7%, p  = 0.05), cardiac arrest (3.9% vs p  = 0.001), cardiogenic shock (3.2% vs p p  = 0.04), venous thromboembolism (4.4% vs. 1.9%, p  = 0.004), and respiratory failure (29.4% vs. 14.8%, p p Conclusion In this nationwide population-based study, 1 in 1000 epilepsy-related hospitalizations were associated with secondary TC which resulted in poor inpatient outcomes and higher healthcare resource utilization.