Annual Absolute Risk of Epilepsy After Stroke. A Nation-Wide Register-Based Cohort Study
Abstract number :
1.373
Submission category :
16. Epidemiology
Year :
2021
Submission ID :
1826195
Source :
www.aesnet.org
Presentation date :
12/4/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:52 AM
Authors :
Mads Ebbesen, MD - Aarhus University; Jakob Christensen - Department of Clinical Medicine, Neurology - Aarhus University; Julie Dreier - Department of Economics and Business Economics, Business and Social Science, The National Center for Register-based Research - Aarhus University; Grethe Andersen - , Department of Neurology, Danish Stroke Center - Aarhus University Hospital; Søren Johnsen - Department of Clinical Medicine, Danish Center for Clinical Health Services Research - Aalborg University
Rationale: Stroke is a common cause of epilepsy, which may include seizures with temporary loss of consciousness. We examined the yearly absolute risk of epilepsy and status epilepticus after stroke, according to stroke type (acute ischemic stroke (AIS), transient ischemic attack (TIA), intracerebral hematoma (ICH)) and stoke severity.
Methods: We included all individuals aged ≥18 years who were residing in Denmark, had no prior epilepsy, and had a first stroke between 1 April 2004 and 16 December 2016. In Denmark, all admissions with acute stroke are included in the Danish Stroke Registry, and information on stroke type, stroke severity, and several stroke risk-factors are included. The primary outcome was the combined outcome of any diagnosis of epilepsy or status epilepticus (ICD-8: 345, ICD-10: G40-G41), as identified in the Danish National Patient Registry. Follow-up began 14 days after the stroke, as early seizures may be part of the acute stroke. Patients were followed from first stroke until the primary outcome, death, emigration or 31 December 2016. We estimated the cumulative incidence of the primary end-point during each of the first 4 years following stroke stratified by stroke type and severity.
Results: In total, 88,119 stroke patients (53.4% male) were included in the study. We identified 7,661 patients with ICH, 70,157 with AIS, and 10,301 with TIA. In total, 3,483 patients were diagnosed with epilepsy within the first 4 years after stroke. The highest risk was observed in the first year after very severe ICH, where the risk of being diagnosed with epilepsy or status epilepticus was 9.8% (95% CI: 7.8-11.7). For comparison, the same number was 5.1% (95% CI: 4.3-5.9) for patients with mild ICH, 7.8% (95% CI: 6.8-8.7) for patients with very severe AIS, and 1.3% (95% CI: 1.2-1.4) for patients with mild AIS. For all groups the, risk decreased in the following years after stroke.
Conclusions: The absolute risk of epilepsy or status epilepticus was higher for ICH patients than for patients with AIS after stroke. The risk was associated with stroke severity. In all of the stroke subgroups, the risk decreased in the years following stroke. Further studies are needed to further stratify the risk according to sex and age.
Funding: Please list any funding that was received in support of this abstract.: The Health Research Foundation of the Central Denmark Region, the Novo Nordisk Foundation, and the Danish Epilepsy Association supported this work.
Epidemiology