TY - JOUR
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
N1 - Funding Information:
Acknowledgments We thank Claudia Steiner, MD, MPH, Senior Research Physician, Healthcare Cost and Utilization Project (HCUP), Center for Delivery, Organization and Markets (CDOM), Agency for Healthcare Quality and Research (AHRQ), for critical review of the manuscript. B.T.B. was supported by the Doris Duke Charitable Foundation. R.L.S. are supported by grants from NINDS (Specialized Program on Translational Research in Acute Stroke, P50 049060). H. C. S. was supported by the NIH training grant PHS 5-T32-NS007155-26.
PY - 2007/12
Y1 - 2007/12
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
UR - http://www.scopus.com/inward/record.url?scp=36949026393&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=36949026393&partnerID=8YFLogxK
U2 - 10.1007/s12028-007-0056-2
DO - 10.1007/s12028-007-0056-2
M3 - Article
C2 - 17503112
AN - SCOPUS:36949026393
VL - 7
SP - 187
EP - 193
JO - Neurocritical Care
JF - Neurocritical Care
SN - 1541-6933
IS - 3
ER -