Effects of resective epilepsy surgery on the social determinants of health

Abstract

Objectives: The aim of this study is to analyze changes in the Social Determinants of Health (SDH) in patients undergoing epilepsy surgery in Mexico.

Materials and methods: We retrospectively analyzed 102 adult patients who underwent brain resection for focal epilepsy (2002-2014) with at least 4 years of follow-up; described clinical variables (age, race, sex, age of onset of epilepsy, age at the time of surgery, type of surgery, side of surgery) and sociodemographic variables including education, income, race/ethnicity, occupation, and marital status.

Statistical analysis: Descriptive and inferential statistics were used.

Results: 54.9% (56) of the participants were women, with a mean age of 38.2 (±9.6) years at the time of the survey. The average and mean duration of drug-resistant epilepsy before surgery after diagnosis was 19.6 (±9.3) years; 77.9% (77) had temporal lobe surgeries and 24.5% (25) had extra-temporal lobe surgeries; 80.4% (82) and 19.6% (20) of patients were classified as Engel I and Engel II, respectively, with at least 4 years of postoperative follow-up. Education level (26.9%, p=<0.001), employment rate (4.9%, p= <0.001), and income (9.8%, p = 0.024) increased after surgery; 20.5% of patients were married after surgery.

Conclusions: Following focal resective epilepsy surgery there was a significant increase in the education level, financial income and employment at 4 years' postoperative follow-up.

Keywords: Difficult-to-control epilepsy; epilepsy surgery; social determinants of health; social position.