Racial Disparity in the Development of Seizure as a Delayed Complication of Subdural Hematoma (P2.9-078)

Objective: Using administrative claims data from a statewide population, we tested the hypothesis that black race is associated with seizures after subdural hematoma (SDH). Background: Seizures are a well-known complication of SDH, occurring in an estimated 43% of patients. Black patients have been found to have increased risk for post-traumatic epilepsy and status epilepticus during SDH admission, but these associations remain poorly understood. Design/Methods: Using claims data on all discharges from emergency departments (ED) and acute care hospitals in California, we identified adult (age>18) patients admitted between 2005 and 2011 with first time SDH. Patients without longitudinal identifiers and non-California residents were excluded. We used validated diagnosis codes to identify a primary outcome of ED or hospital revisit for seizure. We then used Cox regression for survival analysis to identify demographic and medical risk factors for seizure revisit. Results: We identified 34,383 survivors of SDH (mean age 71.4 [SD 16.4], female sex 14,157 [41.5%]). 3,883 (11.3%) patients had revisit for seizure during the study period. Black patients (n=1,931 [5.9%]) had significantly increased risk of seizure following hospitalization for SDH (HR 1.42, CI 1.28–1.59, p Conclusions: We found an association between black race and a heightened risk of seizure after SDH. Disclosure: Dr. Brown has received research support from American Heart Association. Dr. King has nothing to disclose. Dr. Kuohn has nothing to disclose. Dr. Kamel has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Roivant Sciences, Medtronic, BMS, and Roche Diagnostics Corporation. Dr. Kamel has received personal compensation in an editorial capacity for JAMA Neurology. Dr. Kamel has received research support from NIH/NINDS. Dr. Gilmore has nothing to disclose. Dr. Frontera has nothing to disclose. Dr. Falcone has nothing to disclose. Dr. Sheth has received royalty, license fees, or contractual rights payments from Alva Health. Dr. Sheth has received research support from Biogen, Novartis, Bard, and Hyperfine.