Stroke & Applied NeuroScience Center, University of Washington, Seattle WA, USA; Stritch School of Medicine, Loyola University Chicago, Maywood IL, USA; Department of Neurological Surgery, University of Washington, Seattle WA, USA.
Stroke & Applied NeuroScience Center, University of Washington, Seattle WA, USA; Department of Neurological Surgery, University of Washington, Seattle WA, USA.
J Stroke Cerebrovasc Dis. 2024 Dec;33(12):108072. doi: 10.1016/j.jstrokecerebrovasdis.2024.108072. Epub 2024 Oct 12.
Post-stroke seizure (PSS) increases morbidity and mortality after ischemic stroke, but a comprehensive understanding of its incidence and risk factors is lacking. We report the rate and risk factors of PSS at a single institution.
A retrospective cohort study of adult acute ischemic stroke patients between 2018 and 2022 at a comprehensive stroke center was conducted. Patients with a history of seizures, additional stroke during index admission, or death within 7 days of stroke onset were excluded. Early PSS was defined as a new seizure occurring ≤7 days after stroke onset, while late PSS occurred >7 days after stroke onset. Multivariable logistic regression and cox proportional hazard analysis was conducted.
1211 participants met inclusion criteria. Patients were a mean age of 67.82 and were primarily male (58.7 %), white (72.6 %), and non-Hispanic (91.9 %). Incidence of PSS was 8.8 % (n = 106), of which 53.8 % (n = 57) were early and 46.2 % (n = 49) were late. Bivariate analysis identified younger age, diabetes, baseline National Institutes of Health Stroke Scale (NIHSS), Alberta Stroke Program Early Computed Tomography Score ≤5, cortical involvement, and hemorrhagic transformation as significant in the development of PSS. Multivariable cox proportional hazard analysis identified cortical involvement (hazard ratio [HR]: 2.31, 95 % confidence interval [CI] [1,29, 4.14]), NIHSS ≥ 21 (HR: 1.82, 95 % CI [1.02, 3.22]),and younger age (HR: 0.97, 95 % CI [0.96, 0.98]) as significant PSS predictors.
PSS occurred in 8.8 % of patients presenting with ischemic stroke. Hemorrhagic transformation, cortical involvement, high NIHSS, and younger age were significant predictors of PSS.
中风后癫痫发作（PSS）会增加缺血性中风患者的发病率和死亡率，但对其发病率和危险因素的全面了解仍存在不足。我们报告了单一机构的 PSS 发生率和危险因素。
对 2018 年至 2022 年期间在综合卒中中心的成年急性缺血性卒中患者进行了回顾性队列研究。排除了有癫痫发作史、指数入院期间发生其他卒中或卒中发病后 7 天内死亡的患者。早期 PSS 定义为卒中发病后≤7 天发生的新癫痫发作，而晚期 PSS 发生于卒中发病后>7 天。进行了多变量逻辑回归和 Cox 比例风险分析。
1211 名患者符合纳入标准。患者的平均年龄为 67.82 岁，主要为男性（58.7%）、白人（72.6%）和非西班牙裔（91.9%）。PSS 的发生率为 8.8%（n=106），其中 53.8%（n=57）为早期，46.2%（n=49）为晚期。单变量分析发现年龄较小、糖尿病、基线国立卫生研究院卒中量表（NIHSS）评分、阿尔伯塔卒中计划早期计算机断层扫描评分≤5、皮质受累和出血性转化与 PSS 的发生显著相关。多变量 Cox 比例风险分析确定皮质受累（风险比[HR]：2.31，95%置信区间[CI] [1,29, 4.14]）、NIHSS≥21（HR：1.82，95%CI [1.02, 3.22]）和年龄较小（HR：0.97，95%CI [0.96, 0.98]）是 PSS 的显著预测因子。
缺血性中风患者中有 8.8%发生 PSS。出血性转化、皮质受累、高 NIHSS 和年龄较小是 PSS 的显著预测因子。
