Abstracts

Rationale: Although a well-known clinical phenomenon, there still remain some questions regarding the definitions, pathophysiology and epidemiology of poststroke early seizures and of poststroke epilepsy. Several studies of the prevalence and possible predictors of poststroke seizures and epilepsy have been undertaken during the past few decades. The aim of this study is to give an overview of the temporal trends of poststroke seizures and epilepsy during hospitalization for acute stroke in United States.Methods: We reviewed Nationwide Inpatient Sample (NIS) database from 2002 to 2012 for adult hospitalization of AIS as a primary diagnosis using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes 433.xx-437.1. Seizures were defined by ICD-9-CM codes 345.xx and 780.39 as secondary diagnosis. We defined Comorbid conditions by Deyo's modification of Charlson's Comorbidity Index (CCI) and estimated risk of mortality by the 3M™ All Patient Refined DRG (APR DRG) classification System. Our primary outcomes of interest were in-hospital mortality and non-routine discharge (discharge other than home). Chi-square test, Cochran-Armitage trend test and multivariable survey regression models were utilized for analysis.Results: We analyzed a total of 4,312,329(weighted) hospitalizations with AIS of which 257,587 (weighted) (5.7%) had seizures during hospital stay. We also noticed decrement in temporal trend of seizures from 6.2% in 2002 to 5.7% in 2012(p<0.001). The proportions of mortality (5.3% vs. 9.2%, p<0.001) and non-routine discharge (61.9% vs 72.2%, p<0.001) were higher in patients who had seizures. Even after adjusting for confounders (demographics, APRDRG risk of mortality score, hospital characteristics, admission type, IV-tpa use, mechanical thrombectomy), seizures were associated with higher in hospital mortality (OR [Odds Ratio] 1.2, 95% CI[Confidence Interval] 1.1-1.2), p<0.001) and higher odds of non-routine discharge (OR 1.4, 95% CI 1.4-1.5, p<0.001).Conclusions: Stroke is associated with an increased risk of subsequent seizures and epilepsy. If this occurs early during the same hospitalization of stroke then it carries high morbidity, mortality and higher odds of non routine discharged as compared to stroke without occurrence of concomitant seizures.