Abstract TMP108: Rates and Predictors of 1 Year of Readmission with Seizures in Patients with Stroke and Stroke Subtypes Analysis of a National Cohort of 557,033 Stroke Patients


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Abstract

Background: Seizures are known sequelae of stroke but the national estimates of seizure related hospitalization in post stroke period are not known.Objective: To determine the rates and independent predictors of seizure related hospitalization among patients admitted to hospital with intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH) and ischemic stroke (IS).Methods: The study population included patients in the 2013 Nationwide Readmissions Database (NRD) over the age of 18 years with a principal diagnosis of SAH (ICD9 = 430xx), ICH (ICD9 = 431xx) and IS (ICD9 = 433x1 & 434x1). Subjects with a secondary diagnosis of arterio-venous malformation, brain tumor, or traumatic brain injury were excluded. Seizures were defined by ICD9 codes (345.0x-345.5x, 345.7x-345.9x,780.39). Cox proportional hazards analysis was used to assess the relative risk of rate of readmission with seizure for patients in the presence of selected comorbidities and potential confounders such as age, sex, and type of stroke.Results: A total of 557,033 subjects met all eligibility criteria, of which 497,138, (89.3%) were admitted with IS; 43579(7.8%) with ICH and 16316(2.9%) with SAH. The overall estimated 1 year Kaplan Meir seizure free rate (±SE) was 98.99; it was 99.14% and 99.46% in patients with ICH, SAH and IS respectively. After adjustment for potential confounders, independent predictors of re-admission with seizure within 1 year included female gender (odds ratio, 1.14, 95% confidence interval (CI) 1.02-1.27), age≤60 (OR = 1.26, 95 % CI 1.12-1.41),hemorrhagic stroke (ICH/SAH) (OR =1.18;95 % CI 1.02-1.35), seizure during hospitalization (OR = 7.51, 95 % CI 6.70-8.43 and sodium abnormalities during the hospitalization (OR = 1.43, 95 % CI 1.21-1.69).Conclusion: Rate readmission of seizure after stroke within first year is low and there may be residual confounding by severity. Our findings do not support a need for routine prophylactic anti-epileptic drug use after stroke.

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