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创伤后癫痫:来自城市一级创伤中心的观察结果

Post-Traumatic Epilepsy: Observations from an Urban Level 1 Trauma Center.

作者信息

Kotas Daniel, Zhao Huaqing, Turella John, Kasoff Willard S

机构信息

Department of Neurosurgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA.

Department of Biomedical Education and Data Science, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA.

出版信息

Neurol Int. 2024 Aug 5;16(4):845-852. doi: 10.3390/neurolint16040063.

Abstract

There are approximately 2.5 million cases of traumatic brain injury (TBI) in the U.S. each year. Post-traumatic epilepsy (PTE), a sequela of TBI, has been shown to occur in approximately 15% of TBI patients. Pre-disposing risk factors for the development of PTE include severe TBI and penetrating head injury. PTE is associated with poor functional outcomes, increased negative social factors, and mental illness. We conducted a retrospective chart review with a 5-year timeframe at an urban Level 1 Trauma Center. Patients with ICD-10-CM codes associated with TBI were identified. Patients were coded as TBI with or without PTE by the presence of codes associated with PTE. Datapoints collected included risk factors for PTE and encounters with neurologists. A total of 1886 TBI patients were identified, with 178 (9.44%) classified as TBI with PTE. The most significant risk factor associated with PTE was severe brain injury, with an odds ratio (OR) of 2.955 (95% CI [2.062,4.236]; < 0.0001). Only 19 of 178 patients (10.7%) visited a neurologist beyond 6 months after TBI. Our results suggest the presence of a significant population of patients with PTE and the need for better follow-up.

摘要

美国每年约有250万例创伤性脑损伤(TBI)病例。创伤后癫痫(PTE)是TBI的一种后遗症,已证实约15%的TBI患者会发生。PTE发生的易感风险因素包括重度TBI和穿透性头部损伤。PTE与功能预后不良、负面社会因素增加及精神疾病有关。我们在一家城市一级创伤中心进行了一项为期5年的回顾性病历审查。确定了具有与TBI相关的ICD-10-CM编码的患者。根据与PTE相关编码的存在情况,将患者编码为患有或未患有PTE的TBI。收集的数据点包括PTE的风险因素以及与神经科医生的接触情况。共确定了1886例TBI患者,其中178例(9.44%)被分类为患有PTE的TBI。与PTE相关的最显著风险因素是重度脑损伤,优势比(OR)为2.955(95%置信区间[2.062,4.236];P<0.0001)。178例患者中只有19例(10.7%)在TBI后6个月以上就诊于神经科医生。我们的结果表明存在大量PTE患者,且需要更好的随访。

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