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Early seizures in intracerebral hemorrhage: incidence, associated factors, and outcome

Veerle De Herdt UGent, F Dumont, H Henon, P Derambure, Kristl Vonck UGent, D Leys and C Cordonnier (2011) NEUROLOGY. 77(20). p.1794-1800
abstract
Objective: In patients with spontaneous intracerebral hemorrhage (ICH), the occurrence of early seizures (ES) may be a prognostic marker. Therefore, we aimed to identify incidence, associated factors, and influence on outcome of ES in patients with ICH. Methods: Between November 2004 and March 2009, we prospectively recruited 562 consecutive adults with a spontaneous ICH (Prognosis of InTra-Cerebral Hemorrhage cohort). Patients with previous seizures (n = 40) were excluded. ES were defined as seizures occurring within 7 days of stroke onset, and their associated factors were identified with Cox regression. For a subgroup of onset seizures, we used logistic regression. Data influencing outcome (mortality at day 7 and month 6 and functional outcome at month 6) were studied using survival analyses. Results: ES occurred in 71 (14%; 95% confidence interval [CI] 11-17) of 522 patients (274 male; median age 72 years, interquartile range 58-79 years). The only factor associated with ES was cortical involvement of ICH (odds ratio [OR] = 2.06; 95% CI 1.28-3.31). Regarding onset seizures (n = 38) (7%; 95% CI 5-10), associated factors were previous ICH (OR = 4.76; 95% CI 1.53-14.84), cortical involvement (OR = 2.21; 95% CI 1.11-4.43), younger age (OR = 0.97 per 1 year increase; 95% CI 0.95-0.99), and severity of the neurologic deficit at admission (OR = 1.03 per 1 point increase in the National Institutes of Health Stroke Scale score; 95% CI 1.01-1.06). ES did not influence vital or functional outcome. Conclusions: ES are a frequent complication in patients with spontaneous ICH; however, their occurrence does not influence outcome at 6 months.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
seizures, ASSOCIATION/AMERICAN-STROKE-ASSOCIATION, intracranial hemorrhage, PREDICTORS, GUIDELINES, MULTICENTER, STATUS EPILEPTICUS, ISCHEMIC-STROKE, MANAGEMENT, DISEASE, IMPACT, COHORT
journal title
NEUROLOGY
Neurology
volume
77
issue
20
pages
1794 - 1800
Web of Science type
Article
Web of Science id
000297156700011
JCR category
CLINICAL NEUROLOGY
JCR impact factor
8.312 (2011)
JCR rank
7/190 (2011)
JCR quartile
1 (2011)
ISSN
0028-3878
DOI
10.1212/WNL.0b013e31823648a6
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
2003519
handle
http://hdl.handle.net/1854/LU-2003519
date created
2012-01-25 17:32:01
date last changed
2012-02-14 11:04:05
@article{2003519,
  abstract     = {Objective: In patients with spontaneous intracerebral hemorrhage (ICH), the occurrence of early seizures (ES) may be a prognostic marker. Therefore, we aimed to identify incidence, associated factors, and influence on outcome of ES in patients with ICH. 
Methods: Between November 2004 and March 2009, we prospectively recruited 562 consecutive adults with a spontaneous ICH (Prognosis of InTra-Cerebral Hemorrhage cohort). Patients with previous seizures (n = 40) were excluded. ES were defined as seizures occurring within 7 days of stroke onset, and their associated factors were identified with Cox regression. For a subgroup of onset seizures, we used logistic regression. Data influencing outcome (mortality at day 7 and month 6 and functional outcome at month 6) were studied using survival analyses. 
Results: ES occurred in 71 (14\%; 95\% confidence interval [CI] 11-17) of 522 patients (274 male; median age 72 years, interquartile range 58-79 years). The only factor associated with ES was cortical involvement of ICH (odds ratio [OR] = 2.06; 95\% CI 1.28-3.31). Regarding onset seizures (n = 38) (7\%; 95\% CI 5-10), associated factors were previous ICH (OR = 4.76; 95\% CI 1.53-14.84), cortical involvement (OR = 2.21; 95\% CI 1.11-4.43), younger age (OR = 0.97 per 1 year increase; 95\% CI 0.95-0.99), and severity of the neurologic deficit at admission (OR = 1.03 per 1 point increase in the National Institutes of Health Stroke Scale score; 95\% CI 1.01-1.06). ES did not influence vital or functional outcome. 
Conclusions: ES are a frequent complication in patients with spontaneous ICH; however, their occurrence does not influence outcome at 6 months.},
  author       = {De Herdt, Veerle and Dumont, F and Henon, H and Derambure, P and Vonck, Kristl and Leys, D and Cordonnier, C},
  issn         = {0028-3878},
  journal      = {NEUROLOGY},
  keyword      = {seizures,ASSOCIATION/AMERICAN-STROKE-ASSOCIATION,intracranial hemorrhage,PREDICTORS,GUIDELINES,MULTICENTER,STATUS EPILEPTICUS,ISCHEMIC-STROKE,MANAGEMENT,DISEASE,IMPACT,COHORT},
  language     = {eng},
  number       = {20},
  pages        = {1794--1800},
  title        = {Early seizures in intracerebral hemorrhage: incidence, associated factors, and outcome},
  url          = {http://dx.doi.org/10.1212/WNL.0b013e31823648a6},
  volume       = {77},
  year         = {2011},
}

Chicago
DE HERDT, VEERLE, F Dumont, H Henon, P Derambure, Kristl Vonck, D Leys, and C Cordonnier. 2011. “Early Seizures in Intracerebral Hemorrhage: Incidence, Associated Factors, and Outcome.” Neurology 77 (20): 1794–1800.
APA
DE HERDT, V., Dumont, F., Henon, H., Derambure, P., Vonck, K., Leys, D., & Cordonnier, C. (2011). Early seizures in intracerebral hemorrhage: incidence, associated factors, and outcome. NEUROLOGY, 77(20), 1794–1800.
Vancouver
1.
DE HERDT V, Dumont F, Henon H, Derambure P, Vonck K, Leys D, et al. Early seizures in intracerebral hemorrhage: incidence, associated factors, and outcome. NEUROLOGY. 2011;77(20):1794–800.
MLA
DE HERDT, VEERLE, F Dumont, H Henon, et al. “Early Seizures in Intracerebral Hemorrhage: Incidence, Associated Factors, and Outcome.” NEUROLOGY 77.20 (2011): 1794–1800. Print.