Garrard Judith, Harms Susan, Hardie Nancy, Eberly Lynn E, Nitz Nicole, Bland Patricia, Gross Cynthia R, Leppik Ilo E
Division of Health Services Research and Policy, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA.
Ann Neurol. 2003 Jul;54(1):75-85. doi: 10.1002/ana.10593.
Although 1 of 10 nursing home residents is taking an antiepileptic drug (AED), no study to our knowledge has determined whether most residents are already receiving AED treatment when they are admitted or are given these drugs afterward. That differentiation was the focus of this study. The study group consisted of 10,318 residents, 65 years and older, admitted to 510 nursing homes located throughout the United States during the first quarter of 1999. AED prevalence at admission was 7.7%; three fifths had an epilepsy/seizure indication. In a multivariate analysis, factors associated with AED use at admission included epilepsy/seizure, bipolar depression, age group, and cognitive performance. In the follow-up cohort (N = 9,516), postadmission initiation of AEDs was 2.7%; one fifth had an epilepsy/seizure indication. In the multivariate analysis, factors associated with postadmission AED initiation included epilepsy/seizure indication, bipolar depression, age group, peripheral vascular disease, and cognitive performance. This rate of AED postadmission initiation within the first 3 months of admission was much higher than expected, suggesting that new symptoms may develop after admission. Results also show that the rate of AED use in nursing homes is not static.
尽管每10名养老院居民中有1人正在服用抗癫痫药物（AED），但据我们所知，尚无研究确定大多数居民在入院时是否已接受AED治疗，还是之后才服用这些药物。这种区分是本研究的重点。研究组由1999年第一季度入住美国各地510家养老院的10318名65岁及以上居民组成。入院时AED患病率为7.7%；五分之三有癫痫/发作指征。在多变量分析中，与入院时使用AED相关的因素包括癫痫/发作、双相抑郁症、年龄组和认知表现。在随访队列（N = 9516）中，入院后开始使用AED的比例为2.7%；五分之一有癫痫/发作指征。在多变量分析中，与入院后开始使用AED相关的因素包括癫痫/发作指征、双相抑郁症、年龄组、外周血管疾病和认知表现。入院后前3个月内AED开始使用的比例远高于预期，表明入院后可能会出现新症状。结果还表明，养老院中AED的使用比例并非一成不变。
