Association of Mortality and Risk of Epilepsy With Type of Acute Symptomatic Seizure After Ischemic Stroke and an Updated Prognostic Model

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dc.contributor.authorSinka, Lucia
dc.contributor.authorAbraira, Laura
dc.contributor.authorImbach, Lukas L.
dc.contributor.authorZieglgänsberger, Dominik
dc.contributor.authorSantamarina, Estevo
dc.contributor.authorÁlvarez-Sabín, José
dc.contributor.authorFerreira-Atuesta, Carolina
dc.contributor.authorKatan, Mira
dc.contributor.authorScherrer, Natalie
dc.contributor.authorBicciato, Giulio
dc.contributor.authorTerziev, Robert
dc.contributor.authorSimmen, Cyril
dc.date.accessioned2023-08-03T15:40:28Z
dc.date.available2023-08-03T15:40:28Z
dc.date.issued2023
dc.description.abstractenglishImportance: Acute symptomatic seizures occurring within 7 days after ischemic stroke may be associated with an increased mortality and risk of epilepsy. It is unknown whether the type of acute symptomatic seizure influences this risk. Objective: To compare mortality and risk of epilepsy following different types of acute symptomatic seizures. Design, Setting, and Participants: This cohort study analyzed data acquired from 2002 to 2019 from 9 tertiary referral centers. The derivation cohort included adults from 7 cohorts and 2 case-control studies with neuroimaging-confirmed ischemic stroke and without a history of seizures. Replication in 3 separate cohorts included adults with acute symptomatic status epilepticus after neuroimaging-confirmed ischemic stroke. The final data analysis was performed in July 2022. Exposures: Type of acute symptomatic seizure. Main Outcomes and Measures: All-cause mortality and epilepsy (at least 1 unprovoked seizure presenting >7 days after stroke). Results: A total of 4552 adults were included in the derivation cohort (2547 male participants [56%]; 2005 female [44%]; median age, 73 years [IQR, 62-81]). Acute symptomatic seizures occurred in 226 individuals (5%), of whom 8 (0.2%) presented with status epilepticus. In patients with acute symptomatic status epilepticus, 10-year mortality was 79% compared with 30% in those with short acute symptomatic seizures and 11% in those without seizures. The 10-year risk of epilepsy in stroke survivors with acute symptomatic status epilepticus was 81%, compared with 40% in survivors with short acute symptomatic seizures and 13% in survivors without seizures. In a replication cohort of 39 individuals with acute symptomatic status epilepticus after ischemic stroke (24 female; median age, 78 years), the 10-year risk of mortality and epilepsy was 76% and 88%, respectively. We updated a previously described prognostic model (SeLECT 2.0) with the type of acute symptomatic seizures as a covariate. SeLECT 2.0 successfully captured cases at high risk of poststroke epilepsy. Conclusions and Relevance: In this study, individuals with stroke and acute symptomatic seizures presenting as status epilepticus had a higher mortality and risk of epilepsy compared with those with short acute symptomatic seizures or no seizures. The SeLECT 2.0 prognostic model adequately reflected the risk of epilepsy in high-risk cases and may inform decisions on the continuation of antiseizure medication treatment and the methods and frequency of follow-up.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1001/jamaneurol.2023.0611
dc.identifier.instnameinstname:Universidad El Bosquespa
dc.identifier.issn2168-6149
dc.identifier.reponamereponame:Repositorio Institucional Universidad El Bosquespa
dc.identifier.repourlrepourl:https://repositorio.unbosque.edu.co
dc.identifier.urihttps://hdl.handle.net/20.500.12495/11248
dc.language.isoeng
dc.publisherJAMA Neurologyspa
dc.publisher.journalJAMA Neurologyspa
dc.relation.ispartofseriesJAMA Neurology, 2168-6149, 80 (6), 2023, 605-613spa
dc.relation.urihttps://jamanetwork.com/journals/jamaneurology/fullarticle/2802972
dc.rights.accessrightsinfo:eu-repo/semantics/closedAccess
dc.rights.accessrightshttps://purl.org/coar/access_right/c_14cb
dc.rights.localAcceso cerradospa
dc.subjectAdultospa
dc.subjectEnvejecidospa
dc.subjectEstudios de cohortesspa
dc.subjectEpilepsiaspa
dc.subjectMujerspa
dc.subjectHombrespa
dc.subjectHumanosspa
dc.subjectAccidente cerebrovascular isquémicospa
dc.subjectPronósticospa
dc.subjectEstado epilépticospa
dc.subjectIctusspa
dc.subject.keywordsAdultspa
dc.subject.keywordsAgedspa
dc.subject.keywordsCohort Studiesspa
dc.subject.keywordsEpilepsyspa
dc.subject.keywordsFemalespa
dc.subject.keywordsMalespa
dc.subject.keywordsHumansspa
dc.subject.keywordsIschemic Strokespa
dc.subject.keywordsPrognosisspa
dc.subject.keywordsStatus Epilepticusspa
dc.subject.keywordsStrokespa
dc.titleAssociation of Mortality and Risk of Epilepsy With Type of Acute Symptomatic Seizure After Ischemic Stroke and an Updated Prognostic Modelspa
dc.type.coarhttps://purl.org/coar/resource_type/c_6501
dc.type.coarversionhttps://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.driverinfo:eu-repo/semantics/article
dc.type.hasversioninfo:eu-repo/semantics/publishedVersion
dc.type.localArtículo de revista

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Association of Mortality and Risk of Epilepsy with Type of Acute Symptomatic Seizure after Ischemic Stroke and an Updated Prognostic Model
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