Efficacy of antiseizure prophylaxis in chronic subdural hematoma: a cohort study on routinely collected health data
| Autor: | Pascal Lavergne, Marie-Christine Brunet, André Turmel, Sylvine Carrondo Cottin, Paule Lessard Bonaventure, Akli Zetchi, Moujahed Labidi, David Simonyan |
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| Rok vydání: | 2020 |
| Předmět: |
Univariate analysis
Pediatrics medicine.medical_specialty Multivariate analysis business.industry Incidence (epidemiology) medicine.medical_treatment Mortality rate medicine.disease 03 medical and health sciences 0302 clinical medicine Anticonvulsant Hematoma Medicine Ictal 030216 legal & forensic medicine business 030217 neurology & neurosurgery Cohort study |
| Zdroj: | Journal of Neurosurgery. 132:284-288 |
| ISSN: | 1933-0693 0022-3085 |
| DOI: | 10.3171/2018.9.jns182092 |
| Popis: | OBJECTIVEChronic subdural hematoma (CSDH) is a common neurosurgical condition that can result in significant morbidity. The incidence of epileptic events associated with CSDH reported in the literature varies considerably and could potentially increase morbidity and mortality rates. The effectiveness of antiepileptic prophylaxis for this indication remains unclear. The primary objective of this study was to assess the relevance of anticonvulsant prophylaxis in reducing seizure events in patients with CSDH.METHODSAll consecutive cases of CSDH from January 1, 2005, to May 30, 2014, at the Hôpital de l’Enfant-Jésus in Quebec City were retrospectively reviewed. Sociodemographic data, antiepileptic prophylaxis use, incidence of ictal events, and clinical and radiological outcome data were collected. Univariate analyses were done to measure the effect of antiepileptic prophylaxis on ictal events and to identify potential confounding factors. Multivariate logistic regression was performed to evaluate factors associated with epileptic events.RESULTSAntiepileptic prophylaxis was administered in 28% of the patients, and seizures occurred in 11%. Univariate analyses showed an increase in the incidence of ictal events in patients receiving prophylaxis (OR 5.92). Four factors were identified as being associated with seizures: septations inside the hematoma, membranectomy, antiepileptic prophylaxis, and a new deficit postoperatively. Antiepileptic prophylaxis was not associated with seizures in multivariate analyses.CONCLUSIONSAntiepileptic prophylaxis does not seem to be effective in preventing seizures in patients with CSDH. However, due to the design of this study, it is difficult to conclude definitively about the usefulness of this prophylactic therapy that is widely prescribed for this condition. |
| Databáze: | OpenAIRE |
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