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Statistical Data Con't
- Categorized in: 2013 Compendium of Federal Medicine
Uncertain Populations: There are no established ICD-09-CM codes for PNES patients, who generally are coded by neurologists using ICD-09-CM code 780.39. In addition, many patients coded with 780.02 (transient alteration of awareness), 780.2 (syncope and collapse) and 780.09 (alteration of consciousness other) could possibly be PNES patients. In the five-year time period FY 2007 - FY 2011, 288,793 patients had a diagnosis of the above codes. Among these patients, 26,835 patients had a diagnosis of TBI, while 65,113 patients also were diagnosed with PTSD. The estimated prevalence of 140.4 per 1,000 for above-mentioned ICD-9 codes among TBI cohort is consistent with previously estimated prevalence of spells in TBI. However, the prevalence of 70.7 per 1,000 of possible spells among PTSD is higher than that of seizures among PTSD cohort.
Discussion: Data analysis suggests that numbers of seizure, TBI and PTSD patients are increasing in the VA. Similarly numbers of seizure patients among TBI and PTSD cohorts also are rising. High prevalence of seizures among TBI cohort (approximately 140.2 per 1,000) echoes the previous studies done with regard to association of TBI and post-traumatic epilepsy. Prevalence of seizures among PTSD cohort (approximately 48.5 per 1,000 patients) is lower than TBI group but is still alarmingly high. This high prevalence could be attributed, in part, to a high percentage of PNES in this population.
According to VHA office of Public Health’s most recent epidemiology report13, 1,436,522 Operations Enduring Freedom, Iraqi Freedom and New Dawn (OEF/OIF/OND) soldiers have separated from the service since FY 2002, but only about 54% have sought healthcare in the VHA system. As more of them seek care at the VA, the need for specialized care of seizure patients to include TBI and PTSD cohorts will grow.
Data show that ECoEs consistently provide care to one-fifth of seizure patients. With specialized equipment and services, ECoE can play a pivotal role in providing specialized care to fulfill the needs of potential upsurge in the large number of patients with seizures.
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