naa a22 4500 510799337 CHVBK 20180411083348.0 cr unu---uuuuu 180411e20130801xx s 000 0 eng 10.1007/s12028-012-9791-0 doi (NATIONALLICENCE)springer-10.1007/s12028-012-9791-0 Seizures Do Not Increase In-Hospital Mortality After Intracerebral Hemorrhage in the Nationwide Inpatient Sample [Elektronische Daten] [Michael Mullen, Scott Kasner, Steven Messé] Background: Seizures are common after intracerebral hemorrhage (ICH) but their impact on outcome is uncertain and prophylactic anti-convulsant use is controversial. We hypothesized that seizures would not increase the risk of in-hospital mortality in a large administrative database. Methods: The study population included patients in the 2006 Nationwide Inpatient Sample over the age of 18 with a principal diagnosis of ICH (ICD9=431). Subjects with a secondary diagnosis of aneurysm, arterio-venous malformation, brain tumor, or traumatic brain injury were excluded. Seizures were defined by ICD9 codes (345.0x-345.5x, 345.7x-345.9x, 780.39). Logistic regression was used to quantify the relationship between seizures and in-hospital mortality. Pre-specified subgroups included age strata, length of stay, and invasive procedures. Results: 13,033 subjects met all eligibility criteria, of which 1,430 (11.0%) had a secondary diagnosis of seizure. Subjects with seizure were younger (64 vs. 70years, p<0.001), more likely to get craniectomy (2.1 vs. 1.2%, p=0.006), ventriculostomy (8.5 vs. 6.0%, p<0.001), intubation (32.2 vs. 25.9%, p<0.001), and tracheostomy (6.4 vs. 4.2%, p<0.001). Seizure patients had lower in-hospital mortality (24.3 vs. 28.0%, p=0.003). In a multivariable model incorporating patient and hospital level variables, seizures were associated with reduced odds of in-hospital death (OR=0.62, 95% CI 0.52-0.75). Conclusions: A secondary diagnosis of seizure after ICH was not associated with increased in-hospital death overall or in any of the pre-specified subgroups; however, there may be residual confounding by severity. These findings do not support a need for routine prophylactic anti-epileptic drug use after ICH. Springer Science+Business Media New York, 2012 Intracerebral hemorrhage nationallicence Seizures nationallicence Anti-epileptic drugs nationallicence Outcomes nationallicence Classifications: ICH nationallicence Seizures nationallicence Stroke nationallicence Mullen Michael Department of Neurology, University of Pennsylvania, 3400 Spruce Street, 3 W Gates Building, 19104, Philadelphia, PA, USA aut Kasner Scott Department of Neurology, University of Pennsylvania, 3400 Spruce Street, 3 W Gates Building, 19104, Philadelphia, PA, USA aut Messé Steven Department of Neurology, University of Pennsylvania, 3400 Spruce Street, 3 W Gates Building, 19104, Philadelphia, PA, USA aut Neurocritical Care Springer US; http://www.springer-ny.com 19/1(2013-08-01), 19-24 1541-6933 19:1<19 2013 19 12028 https://doi.org/10.1007/s12028-012-9791-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-012-9791-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Mullen Michael Department of Neurology, University of Pennsylvania, 3400 Spruce Street, 3 W Gates Building, 19104, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Kasner Scott Department of Neurology, University of Pennsylvania, 3400 Spruce Street, 3 W Gates Building, 19104, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Messé Steven Department of Neurology, University of Pennsylvania, 3400 Spruce Street, 3 W Gates Building, 19104, Philadelphia, PA, USA aut NATIONALLICENCE 773 0- Neurocritical Care Springer US; http://www.springer-ny.com 19/1(2013-08-01), 19-24 1541-6933 19:1<19 2013 19 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer