Department of Neurology, Oulu University Hospital, Box 25, 90029 OYS, Finland.
Department of Clinical Neurosciences, University of Helsinki, Haartmaninkatu 4, PO Box 22, 00014, Finland.
Epilepsy Res. 2021 May;172:106586. doi: 10.1016/j.eplepsyres.2021.106586. Epub 2021 Feb 17.
This study aimed to determine whether post-stroke epilepsy (PSE) predicts mortality, and to describe the most prominent causes of death (COD) in a long-term follow-up after primary intracerebral hemorrhage (ICH).
We followed 3-month survivors of a population-based cohort of primary ICH patients in Northern Ostrobothnia, Finland, for a median of 8.8 years. Mortality and CODs were compared between those who developed PSE and those who did not. PSE was defined according to the ILAE guidelines. CODs were extracted from death certificates (Statistics Finland).
Of 961 patients, 611 survived for 3 months. 409 (66.9%) had died by the end of the follow-up. Pneumonia was the only COD that was significantly more common among the patients with PSE (56% vs. 37% of deaths). In the multivariable models, PSE (hazard ratio [HR] 1.41, 95% confidence interval [CI] 1.06-1.87), age (HR 1.07, 95% CI 1.06-1.08), male sex (HR 1.35, 95% CI 1.09-1.67), dependency at 3 months (HR 1.52, 95% CI 1.24-1.88), non-subcortical ICH location (subcortical location HR 0.78, 95% CI 0.61-0.99), diabetes (HR 1.43, 95% CI 1.07-1.90) and cancer (HR 1.45, 95% CI 1.06-1.98) predicted death in the long-term follow-up.
PSE independently predicted higher late morality of ICH in our cohort. Pneumonia-related deaths were more common among the patients with PSE.
本研究旨在确定卒中后癫痫（PSE）是否可预测死亡率，并描述原发性脑出血（ICH）后长期随访中最主要的死亡原因（COD）。
我们对芬兰北奥斯特罗波的尼地区基于人群的原发性 ICH 患者队列中 3 个月幸存者进行了随访，中位随访时间为 8.8 年。比较了发生 PSE 和未发生 PSE 的患者的死亡率和 COD。根据 ILAE 指南定义 PSE。从死亡证明中提取 COD（芬兰统计局）。
在 961 例患者中，有 611 例患者存活 3 个月。随访结束时，有 409 例（66.9%）死亡。PSE 组中肺炎是唯一更常见的 COD（56% vs. 37%的死亡）。在多变量模型中，PSE（风险比 [HR] 1.41，95%置信区间 [CI] 1.06-1.87）、年龄（HR 1.07，95% CI 1.06-1.08）、男性（HR 1.35，95% CI 1.09-1.67）、3 个月时依赖（HR 1.52，95% CI 1.24-1.88）、非皮质下 ICH 部位（皮质下部位 HR 0.78，95% CI 0.61-0.99）、糖尿病（HR 1.43，95% CI 1.07-1.90）和癌症（HR 1.45，95% CI 1.06-1.98）预测了长期随访中的死亡。
在我们的队列中，PSE 独立预测了 ICH 患者的晚期死亡率较高。PSE 患者的肺炎相关死亡更为常见。
