Early seizures in first-ever acute stroke patients in India: incidence, predictive factors and impact on early outcome
Early seizures in first-ever acute stroke patients in India: incidence, predictive factors and impact on early outcome
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DOI：
10.1111/j.1468-1331.2012.03782.x
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发表时间：
2012-10-01
影响因子：
5.1
通讯作者：
Ghosh, A.
中科院分区：
文献类型：
--
作者：
Goswami, R. P.;Karmakar, P. S.;Ghosh, A.
背景与目的卒中相关早期癫痫发作（ES）常使急性卒中的初始病程复杂化。本研究旨在评估首次急性脑卒中患者ES的发生率、预测因素以及ES对临床结果的影响。材料与方法前瞻性纳入2010年6月至2011年12月在内科连续收治的首次急性脑卒中患者。ES定义为急性中风后7天内发生的癫痫发作。排除有癫痫史、短暂性脑缺血发作、蛛网膜下腔出血和脑静脉血栓的患者。临床结果在出院时死亡率和残疾的小标题下进行测量，根据修改的兰金评分。结果441例（56.92%为男性，中位年龄55岁相近，49.43%为出血性卒中）患者中，79例（17.91%，95%可信区间（CI）： 14.6121.78%）为ES。出院时致残37.64%，死亡19.5%。在多变量分析中，酗酒、入院时NIHSS、出血性卒中和皮质定位是ES的重要预测因素。入院时NIHSS预测30天死亡率[风险比（HR）： 1.14, 95% CI: 1.111.18， P与
Background and purpose Stroke-associated early seizures (ES) often complicate the initial course of acute stroke. This study intended to estimate the rate of and the predictive factors for ES and the impact of ES on the clinical outcome in patients with first-ever acute stroke. Materials and methods Consecutive patients with first-ever acute stroke admitted in the Department of Medicine from June 2010 to December 2011 were prospectively included. ES were defined as seizures occurring within 7 similar to days from acute stroke. Patients with history of epilepsy, transient ischaemic attack, subarachnoid haemorrhage and cerebral venous thrombosis were excluded. Clinical outcomes were measured under the subheadings of mortality and disability at discharge, according to modified Rankin score. Results Of the 441 (56.92% male patients, median age 55 similar to years, 49.43% had haemorrhagic stroke) patients, 79 (17.91%, 95% confidence interval (CI): 14.6121.78%) suffered from ES. At discharge, 37.64% were disabled, and 19.5% were dead. In multivariate analysis, alcoholism, NIHSS at admission, haemorrhagic stroke and cortical location were significant predictors of ES. Thirty-day mortality was predicted by NIHSS at admission [hazard ratio (HR): 1.14, 95% CI: 1.111.18, P similar to