Abstracts

Rationale: Hypertension, a prevalent chronic disease, is intricately linked with epilepsy, often emerging as a complication. Recent studies suggest that hypertension may independently trigger epilepsy, yet research on the prognosis of epilepsy patients with hypertension remains limited. The aim of this study was to investigate the impact of hypertension and associated comorbidities on the likelihood of direct intensive care unit (ICU) admission among epilepsy patients visiting the emergency room (ER).


Methods: This retrospective study analyzed patients who had seizure and visited the ER of Wonju Severance Christian Hospital between January 1, 2019, and June 30, 2022. Epilepsy diagnoses were confirmed using ICD-10 codes (G40, G41, G56). Comorbidities, including hypertension, cerebrovascular, neurodegenerative, and cardiovascular diseases, were documented through chart review. Blood tests taken within 8 hours of ER admission were analyzed. The primary outcome was ICU admission within 24 hours.


Results: The study included 90 epilepsy patients (mean age 55.44 years, 40% female) who visited the emergency room. Among these patients, 23.3% had a prior diagnosis of hypertension, and 22.2% were directly admitted to the ICU. Patients with a previous diagnosis of hypertension were significantly older (66.10 ± 13.134 years) compared to those without hypertension (52.20 ± 16.354 years, p=0.001). Also, significant associations were identified for elevated brain natriuretic peptide (BNP) levels (p=0.029), ICU admission (p=0.009), and various comorbidities including neurodegenerative diseases (p=0.009), diabetes (p=0.001), dyslipidemia (p=0.006), cardiovascular diseases (p=0.019), and liver and renal diseases (p=0.004 and 0.001, respectively). Additionally, higher white blood cell counts (WBC) (p=0.008), lower erythrocyte sedimentation rates (p=0.009), and elevated levels of cardiac troponin I (p=0.024) and BNP (p=0.036) were notable among patients admitted to the ICU. Multivariate logistic regression analysis revealed that epilepsy patients with a prior diagnosis of hypertension had an odds ratio of 4.073 for direct ICU admission from the ER compared to those without hypertension.


Conclusions: In conclusion, hypertension and associated comorbidities significantly influence the prognosis of epilepsy patients, particularly concerning ICU admissions. The study demonstrated that epilepsy patients with a prior diagnosis of hypertension were more likely to be directly admitted to the ICU from the ER, highlighting the importance of comprehensive monitoring and management of hypertension and related comorbidities in this patient population. Elevated inflammatory and cardiac biomarkers, such as WBC, BNP, and cardiac troponin I, were also potential predictors of ICU admission, underscoring the need for a multidisciplinary approach to optimize outcomes for epilepsy patients with these conditions.


Funding: This research received no external funding.