Analyzing risk factors for late posttraumatic seizures: A prospective, multicenter investigation
Analyzing risk factors for late posttraumatic seizures: A prospective, multicenter investigation
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DOI：
10.1053/apmr.2003.50022
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发表时间：
2003-03-01
影响因子：
4.3
通讯作者：
Bergman, W
中科院分区：
文献类型：
--
作者：
Englander, J;Bushnik, T;Bergman, W
目的：为了确定自然历史和分层风险的发展，晚期创伤后癫痫发作的个人与中度至重度创伤性脑损伤（TBI）。设计：前瞻性，观察性研究的个人与TBI承认4创伤中心内24小时的伤害。设置：四个三级护理创伤中心在城市地区。参与者：共计647人（大于或等于16岁）有以下任何异常计算机断层扫描（CT）扫描结果：中线移位和/或脑池压迫程度或存在任何局灶性病理（例如，点状、蛛网膜下腔或脑室内出血;皮质或皮质下挫伤;轴外损伤）或最佳格拉斯哥昏迷量表（GCS）评分小于或等于10分。受试者从1993年8月至1997年9月入组，随访24个月，直至死亡或首次迟发性创伤后癫痫发作。干预：不适用。主要结果测量：根据人口统计学因素、损伤病因、初始GCS、结果：66例患者有迟发性癫痫发作，337例患者在24个月随访期间无迟发性癫痫发作，167例患者在随访期间无迟发性癫痫发作，167例患者在24个月随访期间无迟发性癫痫发作。
Objectives: To ascertain the natural history and to stratify risks for the development of late posttraumatic seizures in individuals with moderate to severe traumatic brain injury (TBI).Design: Prospective, observational study of individuals with TBI admitted to 4 trauma centers within 24 hours of injury.Setting: Four tertiary care trauma centers in urban areas.Participants: A total of 647 individuals (greater than or equal to16y) with any of the following abnormal computed tomography (CT) scan findings: extent of midline shift and/or cisternal compression or presence of any focal pathology (eg, punctate, subarachnoid, or intraventricular hemorrhage; cortical or subcortical contusion; extra-axial lesions) during the first 7 days postinjury or best Glasgow Coma Scale (GCS) score of less than or equal to10 during the first 24 hours post-TBI. Subjects were enrolled from August 1993 through September 1997 and followed for up to 24 months, until death or their first late posttraumatic seizures.Interventions: Not applicable.Main Outcome Measures: Cumulative probability, relative risk, and survival analyses were used to stratify risks for development of late posttraumatic seizures on the basis of demographic factors, etiology of injury, initial GCS, early posttraumatic seizures, time post-TBI, types of intracerebral lesion by CT scan, and number and types of intracranial procedures.Results: Sixty-six individuals had a late posttraumatic seizures; 337 had no late posttraumatic seizures during full 24-month follow-up; 167 had no late posttraumatic seizures during time followed (