Convulsive status epilepticus after ischemic stroke and intracerebral hemorrhage: Frequency, predictors, and impact on outcome in a large administrative dataset

Brian T. Bateman, Jan Claassen, Joshua Z. Willey, Lawrence J. Hirsch, Stephan A. Mayer, Ralph L Sacco, H. Christian Schumacher

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Objective: Relatively little is known about the epidemiology of generalized convulsive status epilepticus (GCSE) in acute ischemic and hemorrhagic stroke. We examined the occurrence of GCSE in acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH) using a large discharge database. Methods: Data were derived from the Nationwide Inpatient Sample for the years 1994-2002. Using the appropriate ICD-9-CM codes, patients admitted through the emergency room with a diagnosis of AIS or ICH were selected for analysis. From these patients, those coded as having GCSE were identified. Multivariate logistic regression was performed using clinical elements available in the database to identify independent predictors of GCSE. The association between GCSE and various outcome measures was also assessed. Results: The cohort included 718,531 hospitalizations with AIS and 102,763 with ICH. GCSE developed in 1,415 (0.2%) of the AIS cohort and 266 (0.3%) of the ICH cohort. For the AIS cohort, female sex, African American race, renal disease, alcohol abuse, sodium imbalance, and hemorrhagic transformation were associated with higher rates, while increasing age, hypertension, and diabetes mellitus were associated with lower rates of GCSE. For the ICH cohort, African American and Hispanic race, renal disease, coagulopathy, brain tumor, alcohol abuse, and sodium imbalance were associated with higher rates, while increasing age and hypertension were associated with lower rates of GCSE. GCSE was associated with higher rates of adverse outcomes. Conclusions: GCSE is a rare but serious complication in the setting of acute ischemic stroke and intracerebral hemorrhage.

Original languageEnglish
Pages (from-to)187-193
Number of pages7
JournalNeurocritical Care
Volume7
Issue number3
DOIs
StatePublished - Dec 1 2007
Externally publishedYes

Fingerprint

Status Epilepticus
Cerebral Hemorrhage
Stroke
African Americans
Alcoholism
Sodium
Datasets
Databases
Hypertension
Kidney
International Classification of Diseases
Hispanic Americans
Brain Neoplasms
Hospital Emergency Service
Inpatients
Diabetes Mellitus
Epidemiology
Hospitalization
Logistic Models
Outcome Assessment (Health Care)

Keywords

  • Administrative databases
  • Intracerebral hemorrhage
  • Ischemic stroke
  • Nationwide inpatient sample
  • Seizures
  • Status epilepticus

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine

Cite this

Convulsive status epilepticus after ischemic stroke and intracerebral hemorrhage : Frequency, predictors, and impact on outcome in a large administrative dataset. / Bateman, Brian T.; Claassen, Jan; Willey, Joshua Z.; Hirsch, Lawrence J.; Mayer, Stephan A.; Sacco, Ralph L; Schumacher, H. Christian.

In: Neurocritical Care, Vol. 7, No. 3, 01.12.2007, p. 187-193.

Research output: Contribution to journalArticle

Bateman, Brian T. ; Claassen, Jan ; Willey, Joshua Z. ; Hirsch, Lawrence J. ; Mayer, Stephan A. ; Sacco, Ralph L ; Schumacher, H. Christian. / Convulsive status epilepticus after ischemic stroke and intracerebral hemorrhage : Frequency, predictors, and impact on outcome in a large administrative dataset. In: Neurocritical Care. 2007 ; Vol. 7, No. 3. pp. 187-193.
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abstract = "Objective: Relatively little is known about the epidemiology of generalized convulsive status epilepticus (GCSE) in acute ischemic and hemorrhagic stroke. We examined the occurrence of GCSE in acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH) using a large discharge database. Methods: Data were derived from the Nationwide Inpatient Sample for the years 1994-2002. Using the appropriate ICD-9-CM codes, patients admitted through the emergency room with a diagnosis of AIS or ICH were selected for analysis. From these patients, those coded as having GCSE were identified. Multivariate logistic regression was performed using clinical elements available in the database to identify independent predictors of GCSE. The association between GCSE and various outcome measures was also assessed. Results: The cohort included 718,531 hospitalizations with AIS and 102,763 with ICH. GCSE developed in 1,415 (0.2{\%}) of the AIS cohort and 266 (0.3{\%}) of the ICH cohort. For the AIS cohort, female sex, African American race, renal disease, alcohol abuse, sodium imbalance, and hemorrhagic transformation were associated with higher rates, while increasing age, hypertension, and diabetes mellitus were associated with lower rates of GCSE. For the ICH cohort, African American and Hispanic race, renal disease, coagulopathy, brain tumor, alcohol abuse, and sodium imbalance were associated with higher rates, while increasing age and hypertension were associated with lower rates of GCSE. GCSE was associated with higher rates of adverse outcomes. Conclusions: GCSE is a rare but serious complication in the setting of acute ischemic stroke and intracerebral hemorrhage.",
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T1 - Convulsive status epilepticus after ischemic stroke and intracerebral hemorrhage

T2 - Frequency, predictors, and impact on outcome in a large administrative dataset

AU - Bateman, Brian T.

AU - Claassen, Jan

AU - Willey, Joshua Z.

AU - Hirsch, Lawrence J.

AU - Mayer, Stephan A.

AU - Sacco, Ralph L

AU - Schumacher, H. Christian

PY - 2007/12/1

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N2 - Objective: Relatively little is known about the epidemiology of generalized convulsive status epilepticus (GCSE) in acute ischemic and hemorrhagic stroke. We examined the occurrence of GCSE in acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH) using a large discharge database. Methods: Data were derived from the Nationwide Inpatient Sample for the years 1994-2002. Using the appropriate ICD-9-CM codes, patients admitted through the emergency room with a diagnosis of AIS or ICH were selected for analysis. From these patients, those coded as having GCSE were identified. Multivariate logistic regression was performed using clinical elements available in the database to identify independent predictors of GCSE. The association between GCSE and various outcome measures was also assessed. Results: The cohort included 718,531 hospitalizations with AIS and 102,763 with ICH. GCSE developed in 1,415 (0.2%) of the AIS cohort and 266 (0.3%) of the ICH cohort. For the AIS cohort, female sex, African American race, renal disease, alcohol abuse, sodium imbalance, and hemorrhagic transformation were associated with higher rates, while increasing age, hypertension, and diabetes mellitus were associated with lower rates of GCSE. For the ICH cohort, African American and Hispanic race, renal disease, coagulopathy, brain tumor, alcohol abuse, and sodium imbalance were associated with higher rates, while increasing age and hypertension were associated with lower rates of GCSE. GCSE was associated with higher rates of adverse outcomes. Conclusions: GCSE is a rare but serious complication in the setting of acute ischemic stroke and intracerebral hemorrhage.

AB - Objective: Relatively little is known about the epidemiology of generalized convulsive status epilepticus (GCSE) in acute ischemic and hemorrhagic stroke. We examined the occurrence of GCSE in acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH) using a large discharge database. Methods: Data were derived from the Nationwide Inpatient Sample for the years 1994-2002. Using the appropriate ICD-9-CM codes, patients admitted through the emergency room with a diagnosis of AIS or ICH were selected for analysis. From these patients, those coded as having GCSE were identified. Multivariate logistic regression was performed using clinical elements available in the database to identify independent predictors of GCSE. The association between GCSE and various outcome measures was also assessed. Results: The cohort included 718,531 hospitalizations with AIS and 102,763 with ICH. GCSE developed in 1,415 (0.2%) of the AIS cohort and 266 (0.3%) of the ICH cohort. For the AIS cohort, female sex, African American race, renal disease, alcohol abuse, sodium imbalance, and hemorrhagic transformation were associated with higher rates, while increasing age, hypertension, and diabetes mellitus were associated with lower rates of GCSE. For the ICH cohort, African American and Hispanic race, renal disease, coagulopathy, brain tumor, alcohol abuse, and sodium imbalance were associated with higher rates, while increasing age and hypertension were associated with lower rates of GCSE. GCSE was associated with higher rates of adverse outcomes. Conclusions: GCSE is a rare but serious complication in the setting of acute ischemic stroke and intracerebral hemorrhage.

KW - Administrative databases

KW - Intracerebral hemorrhage

KW - Ischemic stroke

KW - Nationwide inpatient sample

KW - Seizures

KW - Status epilepticus

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