Long-term risk of epilepsy after traumatic brain injury in children and young adults: a population-based cohort study
Long-term risk of epilepsy after traumatic brain injury in children and young adults: a population-based cohort study
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DOI：
10.1016/s0140-6736(09)60214-2
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发表时间：
2009-03-01
期刊：
影响因子：
168.9
通讯作者：
Vestergaard, Mogens
中科院分区：
文献类型：
--
作者：
Christensen, Jakob;Pedersen, Marianne G.;Vestergaard, Mogens
创伤性脑损伤后不久癫痫的风险很高，但这种高风险持续多久尚不清楚。我们的目的是评估癫痫的风险长达10年或更长的创伤性脑损伤后，考虑到性别，年龄，严重程度和家族history.Methods我们确定了1605 216人出生在丹麦（1977-2002年）的民事登记系统。我们获得的信息，创伤性脑损伤和癫痫的国家医院注册和估计的相对危险度（RR）与Poisson analysis.Findings癫痫的风险增加后，轻度脑损伤（RR 2.22，95%CI 2.07-2.38），严重脑损伤（7.40，6.16-8.89），颅骨骨折（2.17，1.73-2.71）。在轻度脑损伤（1.51，1.24-1.85）、重度脑损伤（4.29，2.04-9.00）和颅骨骨折（2.06，1.37-3.11）后10年以上，风险增加。轻度和重度损伤的RR随年龄增加而增加，15岁以上轻度（3.51，2.90-4.26）和重度（12.24，8.52-17.57）损伤的RR尤其高。女性的风险（2.49，2.25-2.76）略高于男性（2.01，1.83-2.22）。有癫痫家族史的患者，在轻度癫痫发作后，（5.75，4.56-7.27）和严重脑损伤（10.09，4.20-24.26）.释义脑损伤后癫痫的长期高风险可能为预防创伤后癫痫提供了一个窗口。资助丹麦研究机构，P A Messerschaldom和妻子基金会，Grethe Bonnelycke夫人的基金会
Background The risk of epilepsy shortly after traumatic brain injury is high, but how long this high risk lasts is unknown. We aimed to assess the risk of epilepsy up to 10 years or longer after traumatic brain injury, taking into account sex, age, severity and family history.Methods We identified 1605 216 people born in Denmark (1977-2002) from the Civil Registration System. We obtained information on traumatic brain injury and epilepsy from the National Hospital Register and estimated relative risks (RR) with Poisson analyses.Findings Risk of epilepsy was increased after a mild brain injury (RR 2.22, 95% CI 2.07-2.38), severe brain injury (7.40, 6.16-8.89), and skull fracture (2.17, 1.73-2.71). The risk was increased more than 10 years after mild brain injury (1.51, 1.24-1.85), severe brain injury (4.29, 2.04-9.00), and skull fracture (2.06, 1.37-3.11). RR increased with age at mild and severe injury and was especially high among people older than 15 years of age with mild (3.51, 2.90-4.26) and severe (12.24, 8.52-17.57) injury. The risk was slightly higher in women (2.49, 2.25-2.76) than in men (2.01, 1.83-2.22). Patients with a family history of epilepsy had a notably high risk of epilepsy after mild (5.75, 4.56-7.27) and severe brain injury (10.09, 4.20-24.26).Interpretation The longlasting high risk of epilepsy after brain injury might provide a window for prevention of post-traumatic epilepsy.Funding Danish Research Agency, P A Messerschmidt and Wife's Foundation, Mrs Grethe Bonnelycke's Foundation.