Chaudhry Saqib A, Afzal Mohammad Rauf, Rodriguez Gustavo J, Majidi Shahram, Bundlie Scott, Hassan Ameer E, Suri M Fareed K, Qureshi Adnan I
Department of Neurology and Ophthalmology, Michigan State University.
Zeenat Qureshi Stroke Research Center, Department of Neurology, University of Minnesota, MN, USA.
J Vasc Interv Neurol. 2015 Jul;8(3):56-61.
To determine the association between human immunodeficiency virus (HIV) infection and status epilepticus and compare the outcomes of patients with status epilepticus with or without underlying HIV infection.
Patients with primary diagnosis of status epilepticus (cases) and status asthmaticus (controls) were identified from the 2002-2009 Nationwide Inpatient Sample (NIS) which is representative of all admissions in the United States. We performed logistic regression analysis adjusting for age, gender, co-morbid conditions, including hypertension, diabetes mellitus (DM), renal failure, alcohol use, and opportunistic infections. We compared the in hospital outcomes among patients admitted with status epilepticus in strata defined by underlying HIV infection.
The rate of concurrent status epilepticus and HIV has increased over the last 7 years in hospitalized patients with status epilepticus in United States (0.14%-0.27% p<0.0001). The HIV infection was significantly associated with status epilepticus (odds ratio [OR]: 2.2; 95% confidence interval [CI]: 1.8-2.6; p<0.0001)) after adjusting for age, gender, opportunistic infections, and cardiovascular risk factors. The in-hospital mortality was significantly higher while discharge with none or minimal disability was significantly lower in status epilepticus patients with underlying HIV infection (17.5% vs. 9.9%, p<0.0001) and (50.4% vs. 63.3%, p<0.0001), respectively.
Our study suggests that there is a direct association between HIV infection and status epilepticus. The proportion of patients admitted with concurrent status epilepticus and HIV infections is increasing and such patients have higher rates of poor discharge outcomes.
确定人类免疫缺陷病毒（HIV）感染与癫痫持续状态之间的关联，并比较有或无潜在HIV感染的癫痫持续状态患者的预后。
从2002 - 2009年全国住院患者样本（NIS）中识别出原发性诊断为癫痫持续状态（病例）和哮喘持续状态（对照）的患者，该样本代表了美国所有住院病例。我们进行了逻辑回归分析，对年龄、性别、合并症进行了校正，合并症包括高血压、糖尿病（DM）、肾衰竭、酒精使用和机会性感染。我们比较了在潜在HIV感染定义的分层中因癫痫持续状态入院患者的院内结局。
在美国，过去7年中住院的癫痫持续状态患者中，同时存在癫痫持续状态和HIV感染的比例有所增加（从0.14%升至0.27%，p<0.0001）。在对年龄、性别、机会性感染和心血管危险因素进行校正后，HIV感染与癫痫持续状态显著相关（优势比[OR]：2.2；95%置信区间[CI]：1.8 - 2.6；p<0.0001）。有潜在HIV感染的癫痫持续状态患者的院内死亡率显著更高，而无残疾或轻度残疾出院的比例显著更低（分别为17.5%对9.9%，p<0.0001）和（50.4%对63.3%，p<0.0001）。
我们的研究表明HIV感染与癫痫持续状态之间存在直接关联。同时患有癫痫持续状态和HIV感染的入院患者比例正在增加，且此类患者出院时不良结局的发生率更高。
