Shahram Majidi1, Yamane Makke2, Amr Ewida2, Bahareh Sianati2, Adnan I Qureshi3, Mohamad Z Koubeissi2. 1. Department of Neurology, George Washington University, 2150 Pennsylvania Avenue NW, 9th Floor, Washington, DC, 20037, USA. majidis@gwu.edu. 2. Department of Neurology, George Washington University, 2150 Pennsylvania Avenue NW, 9th Floor, Washington, DC, 20037, USA. 3. Zeenat Qureshi Stroke Institute, St. Cloud, MN, USA.
Abstract
BACKGROUND: Traumatic brain injury (TBI) is a well-known risk factor for seizures. We aimed to identify the frequency and risk factors for seizure occurrence during hospitalization for TBI. METHODS: We used ICD-9-CM codes to identify patients 18 years of age or older from the National Trauma Data Bank who were admitted with TBI. We also used ICD-9-CM codes to identify the subset who had seizures during hospitalization. Patient demographics, comorbidities, Glasgow Coma Scale (GCS) score, Injury Severity Score Abbreviated Injury Scale (ISSAIS), in-hospital complications, and discharge disposition were compared in the seizure group (SG) and no-seizure group (NSG). RESULTS: A total of 1559 patients had in-hospital seizures, comprising 0.4% of all patients admitted with TBI. The mean age of SG was 3 years older than NSG [51 vs. 48; p < 0.0001]. African-American ethnicity (20 vs. 12%, p < 0.0001) and moderate TBI (8 vs. 4%, p < 0.0001) were more common in SG. History of alcohol dependence was more common in the SG (25 vs. 11%, p < 0.0001). Fall was the most common mechanism of injury in SG (56 vs. 36% in NSG; p < 0.0001). Subdural hematoma was more common in SG (31 vs. 21%, p < 0.0001). SG had higher rates of pneumonia, ARDS, acute kidney injury, and increased ICP. The average length of hospital stay was significantly higher in SG (10 vs. 6 days, p < 0.0001), and these patients had higher rate of discharge to nursing facility (32 vs. 25%, p < 0.0001). CONCLUSION: In-hospital seizures occur in 0.4% of all TBI patients. Although infrequent, seizure occurrence is associated with higher rates of hospital complications such as pneumonia and ARDS and is an independent predictor of longer hospital stay and worse hospital outcome.
BACKGROUND:Traumatic brain injury (TBI) is a well-known risk factor for seizures. We aimed to identify the frequency and risk factors for seizure occurrence during hospitalization for TBI. METHODS: We used ICD-9-CM codes to identify patients 18 years of age or older from the National Trauma Data Bank who were admitted with TBI. We also used ICD-9-CM codes to identify the subset who had seizures during hospitalization. Patient demographics, comorbidities, Glasgow Coma Scale (GCS) score, Injury Severity Score Abbreviated Injury Scale (ISSAIS), in-hospital complications, and discharge disposition were compared in the seizure group (SG) and no-seizure group (NSG). RESULTS: A total of 1559 patients had in-hospital seizures, comprising 0.4% of all patients admitted with TBI. The mean age of SG was 3 years older than NSG [51 vs. 48; p < 0.0001]. African-American ethnicity (20 vs. 12%, p < 0.0001) and moderate TBI (8 vs. 4%, p < 0.0001) were more common in SG. History of alcohol dependence was more common in the SG (25 vs. 11%, p < 0.0001). Fall was the most common mechanism of injury in SG (56 vs. 36% in NSG; p < 0.0001). Subdural hematoma was more common in SG (31 vs. 21%, p < 0.0001). SG had higher rates of pneumonia, ARDS, acute kidney injury, and increased ICP. The average length of hospital stay was significantly higher in SG (10 vs. 6 days, p < 0.0001), and these patients had higher rate of discharge to nursing facility (32 vs. 25%, p < 0.0001). CONCLUSION: In-hospital seizures occur in 0.4% of all TBI patients. Although infrequent, seizure occurrence is associated with higher rates of hospital complications such as pneumonia and ARDS and is an independent predictor of longer hospital stay and worse hospital outcome.
Authors: Anne C Ritter; Amy K Wagner; Anthony Fabio; Mary Jo Pugh; William C Walker; Jerzy P Szaflarski; Ross D Zafonte; Allen W Brown; Flora M Hammond; Tamara Bushnik; Douglas Johnson-Greene; Timothy Shea; Jason W Krellman; Joseph A Rosenthal; Laura E Dreer Journal: Epilepsia Date: 2016-10-14 Impact factor: 5.864
Authors: P M Vespa; M R Nuwer; V Nenov; E Ronne-Engstrom; D A Hovda; M Bergsneider; D F Kelly; N A Martin; D P Becker Journal: J Neurosurg Date: 1999-11 Impact factor: 5.115
Authors: Paul M Vespa; Chad Miller; David McArthur; Mathew Eliseo; Maria Etchepare; Daniel Hirt; Thomas C Glenn; Neil Martin; David Hovda Journal: Crit Care Med Date: 2007-12 Impact factor: 7.598
Authors: Shahid Shafi; Carlos Marquez de la Plata; Ramon Diaz-Arrastia; Kristin Shipman; Mary Carlile; Heidi Frankel; Jennifer Parks; Larry M Gentilello Journal: J Trauma Date: 2007-12
Authors: Daniel H Arndt; Jason T Lerner; Joyce H Matsumoto; Andranik Madikians; Sue Yudovin; Hannah Valino; David L McArthur; Joyce Y Wu; Michelle Leung; Farzad Buxey; Conrad Szeliga; Michele Van Hirtum-Das; Raman Sankar; Amy Brooks-Kayal; Christopher C Giza Journal: Epilepsia Date: 2013-09-13 Impact factor: 5.864
Authors: Samuel W Cramer; Isabela Peña Pino; Anant Naik; Danielle Carlson; Michael C Park; David P Darrow Journal: BMJ Open Date: 2022-07-13 Impact factor: 3.006
Authors: Ugur Damar; Roman Gersner; Joshua T Johnstone; Kush Kapur; Stephen Collins; Steven Schachter; Alexander Rotenberg Journal: J Neurotrauma Date: 2017-11-21 Impact factor: 5.269
Authors: Jilske A Huijben; Victor Volovici; Maryse C Cnossen; Iain K Haitsma; Nino Stocchetti; Andrew I R Maas; David K Menon; Ari Ercole; Giuseppe Citerio; David Nelson; Suzanne Polinder; Ewout W Steyerberg; Hester F Lingsma; Mathieu van der Jagt Journal: Crit Care Date: 2018-04-13 Impact factor: 9.097