Exacerbation of hepatic cirrhosis may trigger admission for epilepsy and status epilepticus.
Exacerbation of hepatic cirrhosis may trigger admission for epilepsy and status epilepticus.
复制标题
肝硬化恶化可能会引发癫痫和癫痫持续状态入院。
DOI：
10.1111/epi.16437
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发表时间：
2020
期刊：
影响因子：
5.6
通讯作者：
Dhamoon,MandipS
中科院分区：
文献类型：
--
作者：
Gursky,JonathanM;Rossi,KyleC;Jetté,Nathalie;Dhamoon,MandipS
目的确定肝硬化肝病急性加重是否与癫痫或癫痫持续状态再入院的较高几率相关。方法纽约州住院患者数据库是一个全州范围的数据集，包含纽约州97%的住院数据。在这项回顾性、病例交叉设计研究中，我们使用《国际疾病分类》第九版临床修改代码来识别癫痫持续状态和癫痫入院情况。初次暴露被定义为因肝硬化急性加重而入院。病例交叉分析测试了与病例期前1年的对照期相比，在逐渐延长的病例期（入院前14、30、60、90、120、150和180天）暴露于肝脏恶化是否与癫痫或癫痫持续状态再入院有关。结果暴露于肝硬化肝病急性加重后因癫痫入院的优势比在30天窗期为2.072(95%可信区间[CI] = 1.095‐3.92，P= 0.0252)，在150天窗期达到峰值，为2.742 （95% CI = 1.817‐4.137，P< 0.0001）。在癫痫持续状态组中，所有病例期均显示肝恶化后再次入院的几率显著升高。肝恶化与多个时间段内癫痫和癫痫持续状态住院的几率增加相关。
ObjectiveTo determine whether acute exacerbations of cirrhotic liver disease are associated with higher odds of readmission for epilepsy or status epilepticus.MethodsThe New York State Inpatient Database is a statewide dataset containing data on 97% of hospitalizations for New York State. In this retrospective, case‐crossover design study, we used International Classification of Diseases, Ninth Revision, Clinical Modification codes to identify index status epilepticus and epilepsy admissions. The primary exposure was defined as admission due to an acute exacerbation of cirrhotic liver disease. The case‐crossover analysis tested whether exposure to a hepatic exacerbation within progressively longer case periods (14, 30, 60, 90, 120, 150, and 180 days before index admission), compared to control periods 1 year before the case period, was associated with readmission for epilepsy or status epilepticus.ResultsThe odds ratio for subsequent admission for epilepsy after exposure to an acute exacerbation of cirrhotic liver disease was significant in the 30‐day window at 2.072 (95% confidence interval [CI] = 1.095‐3.92,P= .0252) and peaked in the 150‐day window at 2.742 (95% CI = 1.817‐4.137,P< .0001). In the status epilepticus group, all case periods demonstrated significantly elevated odds of subsequent admission following hepatic exacerbation.SignificanceHepatic exacerbations are associated with increased odds for hospital admissions for epilepsy and status epilepticus across several timeframes.