Long‐term continuation of anti‐seizure medications after acute stroke
| Autor: | Pradeep Chandan, Adithya Sivaraju, Vineet Punia, Christopher R. Newey, Nicolas R. Thompson, Ryan D. Honomichl, Pravin George, Irene L. Katzan, Stephen Hantus, Lisa Ellison |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Subarachnoid hemorrhage Time Factors Neurosciences. Biological psychiatry. Neuropsychiatry Logistic regression Seizures Internal medicine Medicine Humans RC346-429 Stroke Research Articles Aged Cerebral Hemorrhage Ischemic Stroke Retrospective Studies Intracerebral hemorrhage business.industry General Neuroscience Retrospective cohort study Symptomatic seizures Electroencephalography Odds ratio Middle Aged Subarachnoid Hemorrhage medicine.disease Hemorrhagic Stroke Acute Disease Population study Anticonvulsants Female Neurology (clinical) Neurology. Diseases of the nervous system business Research Article RC321-571 |
| Zdroj: | Annals of Clinical and Translational Neurology, Vol 8, Iss 9, Pp 1857-1866 (2021) Annals of Clinical and Translational Neurology |
| ISSN: | 2328-9503 |
| Popis: | Objective To investigate the factors associated with the long‐term continuation of anti‐seizure medications (ASMs) in acute stroke patients. Methods We performed a retrospective cohort study of stroke patients with concern for acute symptomatic seizures (ASySs) during hospitalization who subsequently visited the poststroke clinic. All patients had continuous EEG (cEEG) monitoring. We generated a multivariable logistic regression model to analyze the factors associated with the primary outcome of continued ASM use after the first poststroke clinic visit. Results A total of 507 patients (43.4% ischemic stroke, 35.7% intracerebral hemorrhage, and 20.9% aneurysmal subarachnoid hemorrhage) were included. Among them, 99 (19.5%) suffered from ASySs, 110 (21.7%) had epileptiform abnormalities (EAs) on cEEG, and 339 (66.9%) had neither. Of the 294 (58%) patients started on ASMs, 171 (33.7%) were discharged on them, and 156 (30.3% of the study population; 53.1% of patients started on ASMs) continued ASMs beyond the first poststroke clinic visit [49.7 (±31.7) days after cEEG]. After adjusting for demographical, stroke‐ and hospitalization‐related variables, the only independent factors associated with the primary outcome were admission to the NICU [Odds ratio (OR) 0.37 (95% CI 0.15–0.9)], the presence of ASySs [OR 20.31(95% CI 9.45–48.43)], and EAs on cEEG [OR 2.26 (95% CI 1.14–4.58)]. Interpretation Almost a third of patients with poststroke ASySs concerns may continue ASMs for the long term, including more than half started on them acutely. Admission to the NICU may lower the odds, and ASySs (convulsive or electrographic) and EAs on cEEG significantly increase the odds of long‐term ASM use. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|