Hospital Revisits for Post-Ischemic Stroke Epilepsy after Acute Stroke Interventions.
Hospital Revisits for Post-Ischemic Stroke Epilepsy after Acute Stroke Interventions.
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DOI：
10.1016/j.jstrokecerebrovasdis.2021.106155
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发表时间：
2022-01
期刊：
影响因子：
--
通讯作者：
Kim JA
中科院分区：
文献类型：
--
作者：
Kuohn LR;Herman AL;Soto AL;Brown SC;Gilmore EJ;Hirsch LJ;Matouk CC;Sheth KN;Kim JA
急性卒中护理的改善导致缺血性卒中幸存者的增加，他们有发生缺血性卒中后癫痫（PISE）的风险。诸如取栓和溶栓等治疗方法对PISE住院复诊风险的影响尚不清楚。我们利用行政数据来调查脑卒中治疗与pise相关就诊之间的关系。使用来自加利福尼亚、纽约和佛罗里达的索赔数据，我们对急性缺血性中风的成年幸存者进行了回顾性分析。排除有癫痫、外伤、感染或肿瘤病史的患者。纳入的患者随访的主要结果是癫痫发作或癫痫的复诊。Cox比例风险回归用于识别与PISE相关的协变量。在纳入的595,545例患者（中位年龄为74岁[IQR 21]， 52%为女性）中，6年与pise相关的重访累积率为2.20% （95% CI 2.16-2.24）。在调整了人口统计学、合并症和卒中严重程度指标的多变量模型中，IV-tPA （HR 1.42, 95% CI 1.31-1.54, p<0.001）与pci相关的重访相关，而MT （HR 1.62, 95% CI 0.90-1.50, p=0.2）与此无关。行减压颅骨切除术的患者复发PISE的几率增加了2倍（HR 2.35, 95% CI 1.69-3.26, p<0.001）。住院癫痫发作（HR 4.06, 95% CI 3.76-4.39, p<0.001）也增加了PISE的风险。我们证明，接受IV-tPA、进行减压颅骨切除术或经历急性癫痫发作的缺血性卒中幸存者与pise相关的重访风险增加。应密切关注这些患者的长期发展和PISE再次住院的可能性增加。
Improvements in acute stroke care have led to an increase in ischemic stroke survivors, who are at risk for development of post-ischemic stroke epilepsy (PISE). The impact of therapies such as thrombectomy and thrombolysis on risk of hospital revisits for PISE is unclear. We utilized administrative data to investigate the association between stroke treatment and PISE-related visits. Using claims data from California, New York, and Florida, we performed a retrospective analysis of adult survivors of acute ischemic strokes. Patients with history of epilepsy, trauma, infections, or tumors were excluded. Included patients were followed for a primary outcome of revisits for seizures or epilepsy. Cox proportional hazards regression was used to identify covariates associated with PISE. In 595,545 included patients (median age 74 [IQR 21], 52% female), the 6-year cumulative rate of PISE-related revisit was 2.20% (95% CI 2.16–2.24). In multivariable models adjusting for demographics, comorbidities, and indicators of stroke severity, IV-tPA (HR 1.42, 95% CI 1.31–1.54, p<0.001) but not MT (HR 1.62, 95% CI 0.90–1.50, p=0.2) was associated with PISE-related revisit. Patients who underwent decompressive craniectomy experienced a 2-fold increase in odds for returning with PISE (HR 2.35, 95% CI 1.69–3.26, p<0.001). In-hospital seizures (HR 4.06, 95% CI 3.76–4.39, p<0.001) also elevated risk for PISE. We demonstrate that ischemic stroke survivors who received IV-tPA, underwent decompressive craniectomy, or experienced acute seizures were at increased risk PISE-related revisit. Close attention should be paid to these patients with increased potential for long-term development of and re-hospitalization for PISE.
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MR CLEAN，荷兰一项急性缺血性中风血管内治疗的多中心随机临床试验：随机对照试验的研究方案。
影响因子：
2.5
作者：
Fransen PS;Beumer D;Berkhemer OA;van den Berg LA;Lingsma H;van der Lugt A;van Zwam WH;van Oostenbrugge RJ;Roos YB;Majoie CB;Dippel DW;MR CLEAN Investigators
通讯作者：
MR CLEAN Investigators
DOI：
10.3988/jcn.2005.1.1.59
发表时间：
2005-04
期刊：
Journal of clinical neurology (Seoul, Korea)
影响因子：
--
作者：
Kim JS;Choi-Kwon S;Kwon SU;Lee HJ;Park KA;Seo YS
通讯作者：
Seo YS
影响因子：
8.3
作者：
Graham, Neil S. N.;Crichton, Siobhan;Rudd, Anthony G.
通讯作者：
Rudd, Anthony G.
影响因子：
2.6
作者：
Kim, Hyeon Jin;Park, Kee Duk;Lee, Hyang Woon
通讯作者：
Lee, Hyang Woon
影响因子：
3
作者：
Moore, Brian J.;White, Susan;Elixhauser, Anne
通讯作者：
Elixhauser, Anne