Risk factors for epilepsy after thrombolysis for ischemic stroke : a cohort study
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/250278 |
Resumo: | The effects of thrombolysis in seizure and epilepsy after acute ischemic stroke have been poorly explored. In this study, we examine risk factors and consequences of intravenous rt-PA for treatment of acute ischemic stroke. In a retrospective cohort study we evaluate risk factors for seizure and epilepsy after stroke thrombolysis, as well as the impact of seizures and epilepsy in outcome of stroke patients. In our cohort, mean age of patients was 67.2 years old (SD = 13.1) and 79 of them (51.6%) were male and. Initial NIHSS mean score were 10.95 (SD = 6.25). Three months NIHSS mean score was 2.09 (SD = 3.55). Eighty seven (56.9%) patients were mRS of 0–1 after thrombolysis. Hemorrhagic transformation was observed in 22 (14.4%) patients. Twenty-one (13.7%) patients had seizures and 15 (9.8%) patients developed epilepsy after thrombolysis. Seizures were independently associated with hemorrhagic transformation (OR = 3.26; 95% CI = 1.08–9.78; p = 0.035) and with mRS >= 2 at 3 months after stroke (OR = 3.51; 95% CI = 1.20–10.32; p = 0.022). Hemorrhagic transformation (OR = 3.55; 95% CI = 1.11–11.34; p = 0.033) and mRS >= 2 at 3 months (OR = 5.82; 95% CI = 1.45–23.42; p = 0.013) were variables independently associated with post-stroke epilepsy. In our study, independent risks factors for poor outcome in stroke thrombolysis were age (OR = 1.03; 95% CI = 1.01–1.06; p = 0.011), higher NIHSS (OR = 1.08; 95% CI = 1.03– 1.14; p = 0.001), hemorrhagic transformation (OR = 2.33; 95% CI = 1.11–4.76; p = 0.024), seizures (OR = 3.07; 95% CI = 1.22–7.75; p = 0.018) and large cortical area (ASPECTS <= 7) (OR = 2.04; 95% CI = 1.04–3.84; p = 0.036). Concluding, in this retrospective cohort study, the neurological impairment after thrombolysis (but not before) and hemorrhagic transformation remained independent risk factors for seizures or post-stroke epilepsy after thrombolysis. Moreover, we observed that seizures emerged as an independent risk factor for poor outcome after thrombolysis therapy in stroke patients (OR = 3.07; 95% CI = 1.22–7.75; p = 0.018). |
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Brondani, RosaneAlmeida, Andrea Garcia deCherubini, Pedro AbrahimSecchi, Thaís LeiteOliveira, Marina Amaral deMartins, Sheila Cristina OuriquesBianchin, Marino Muxfeldt2022-10-26T04:46:40Z20201664-2295http://hdl.handle.net/10183/250278001149719The effects of thrombolysis in seizure and epilepsy after acute ischemic stroke have been poorly explored. In this study, we examine risk factors and consequences of intravenous rt-PA for treatment of acute ischemic stroke. In a retrospective cohort study we evaluate risk factors for seizure and epilepsy after stroke thrombolysis, as well as the impact of seizures and epilepsy in outcome of stroke patients. In our cohort, mean age of patients was 67.2 years old (SD = 13.1) and 79 of them (51.6%) were male and. Initial NIHSS mean score were 10.95 (SD = 6.25). Three months NIHSS mean score was 2.09 (SD = 3.55). Eighty seven (56.9%) patients were mRS of 0–1 after thrombolysis. Hemorrhagic transformation was observed in 22 (14.4%) patients. Twenty-one (13.7%) patients had seizures and 15 (9.8%) patients developed epilepsy after thrombolysis. Seizures were independently associated with hemorrhagic transformation (OR = 3.26; 95% CI = 1.08–9.78; p = 0.035) and with mRS >= 2 at 3 months after stroke (OR = 3.51; 95% CI = 1.20–10.32; p = 0.022). Hemorrhagic transformation (OR = 3.55; 95% CI = 1.11–11.34; p = 0.033) and mRS >= 2 at 3 months (OR = 5.82; 95% CI = 1.45–23.42; p = 0.013) were variables independently associated with post-stroke epilepsy. In our study, independent risks factors for poor outcome in stroke thrombolysis were age (OR = 1.03; 95% CI = 1.01–1.06; p = 0.011), higher NIHSS (OR = 1.08; 95% CI = 1.03– 1.14; p = 0.001), hemorrhagic transformation (OR = 2.33; 95% CI = 1.11–4.76; p = 0.024), seizures (OR = 3.07; 95% CI = 1.22–7.75; p = 0.018) and large cortical area (ASPECTS <= 7) (OR = 2.04; 95% CI = 1.04–3.84; p = 0.036). Concluding, in this retrospective cohort study, the neurological impairment after thrombolysis (but not before) and hemorrhagic transformation remained independent risk factors for seizures or post-stroke epilepsy after thrombolysis. Moreover, we observed that seizures emerged as an independent risk factor for poor outcome after thrombolysis therapy in stroke patients (OR = 3.07; 95% CI = 1.22–7.75; p = 0.018).application/pdfengFrontiers in neurology. [Lausanne]. Vol. 10 (2020), 1256, 10 p.ReperfusãoEpilepsiaAcidente vascular cerebralConvulsõesAtivador de plasminogênio tecidualReperfusion therapyPost-stroke epilepsyAcute seizuresStroke outcomert-PARisk factors for epilepsy after thrombolysis for ischemic stroke : a cohort studyEstrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001149719.pdf.txt001149719.pdf.txtExtracted Texttext/plain58372http://www.lume.ufrgs.br/bitstream/10183/250278/2/001149719.pdf.txt98f904acac1b793f1789e0e848bf77a0MD52ORIGINAL001149719.pdfTexto completo (inglês)application/pdf257510http://www.lume.ufrgs.br/bitstream/10183/250278/1/001149719.pdf722e9852f6495c114cb1bf53459ea61fMD5110183/2502782022-10-27 04:49:44.947888oai:www.lume.ufrgs.br:10183/250278Repositório InstitucionalPUBhttps://lume.ufrgs.br/oai/requestlume@ufrgs.bropendoar:2022-10-27T07:49:44Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Risk factors for epilepsy after thrombolysis for ischemic stroke : a cohort study |
title |
Risk factors for epilepsy after thrombolysis for ischemic stroke : a cohort study |
spellingShingle |
Risk factors for epilepsy after thrombolysis for ischemic stroke : a cohort study Brondani, Rosane Reperfusão Epilepsia Acidente vascular cerebral Convulsões Ativador de plasminogênio tecidual Reperfusion therapy Post-stroke epilepsy Acute seizures Stroke outcome rt-PA |
title_short |
Risk factors for epilepsy after thrombolysis for ischemic stroke : a cohort study |
title_full |
Risk factors for epilepsy after thrombolysis for ischemic stroke : a cohort study |
title_fullStr |
Risk factors for epilepsy after thrombolysis for ischemic stroke : a cohort study |
title_full_unstemmed |
Risk factors for epilepsy after thrombolysis for ischemic stroke : a cohort study |
title_sort |
Risk factors for epilepsy after thrombolysis for ischemic stroke : a cohort study |
author |
Brondani, Rosane |
author_facet |
Brondani, Rosane Almeida, Andrea Garcia de Cherubini, Pedro Abrahim Secchi, Thaís Leite Oliveira, Marina Amaral de Martins, Sheila Cristina Ouriques Bianchin, Marino Muxfeldt |
author_role |
author |
author2 |
Almeida, Andrea Garcia de Cherubini, Pedro Abrahim Secchi, Thaís Leite Oliveira, Marina Amaral de Martins, Sheila Cristina Ouriques Bianchin, Marino Muxfeldt |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Brondani, Rosane Almeida, Andrea Garcia de Cherubini, Pedro Abrahim Secchi, Thaís Leite Oliveira, Marina Amaral de Martins, Sheila Cristina Ouriques Bianchin, Marino Muxfeldt |
dc.subject.por.fl_str_mv |
Reperfusão Epilepsia Acidente vascular cerebral Convulsões Ativador de plasminogênio tecidual |
topic |
Reperfusão Epilepsia Acidente vascular cerebral Convulsões Ativador de plasminogênio tecidual Reperfusion therapy Post-stroke epilepsy Acute seizures Stroke outcome rt-PA |
dc.subject.eng.fl_str_mv |
Reperfusion therapy Post-stroke epilepsy Acute seizures Stroke outcome rt-PA |
description |
The effects of thrombolysis in seizure and epilepsy after acute ischemic stroke have been poorly explored. In this study, we examine risk factors and consequences of intravenous rt-PA for treatment of acute ischemic stroke. In a retrospective cohort study we evaluate risk factors for seizure and epilepsy after stroke thrombolysis, as well as the impact of seizures and epilepsy in outcome of stroke patients. In our cohort, mean age of patients was 67.2 years old (SD = 13.1) and 79 of them (51.6%) were male and. Initial NIHSS mean score were 10.95 (SD = 6.25). Three months NIHSS mean score was 2.09 (SD = 3.55). Eighty seven (56.9%) patients were mRS of 0–1 after thrombolysis. Hemorrhagic transformation was observed in 22 (14.4%) patients. Twenty-one (13.7%) patients had seizures and 15 (9.8%) patients developed epilepsy after thrombolysis. Seizures were independently associated with hemorrhagic transformation (OR = 3.26; 95% CI = 1.08–9.78; p = 0.035) and with mRS >= 2 at 3 months after stroke (OR = 3.51; 95% CI = 1.20–10.32; p = 0.022). Hemorrhagic transformation (OR = 3.55; 95% CI = 1.11–11.34; p = 0.033) and mRS >= 2 at 3 months (OR = 5.82; 95% CI = 1.45–23.42; p = 0.013) were variables independently associated with post-stroke epilepsy. In our study, independent risks factors for poor outcome in stroke thrombolysis were age (OR = 1.03; 95% CI = 1.01–1.06; p = 0.011), higher NIHSS (OR = 1.08; 95% CI = 1.03– 1.14; p = 0.001), hemorrhagic transformation (OR = 2.33; 95% CI = 1.11–4.76; p = 0.024), seizures (OR = 3.07; 95% CI = 1.22–7.75; p = 0.018) and large cortical area (ASPECTS <= 7) (OR = 2.04; 95% CI = 1.04–3.84; p = 0.036). Concluding, in this retrospective cohort study, the neurological impairment after thrombolysis (but not before) and hemorrhagic transformation remained independent risk factors for seizures or post-stroke epilepsy after thrombolysis. Moreover, we observed that seizures emerged as an independent risk factor for poor outcome after thrombolysis therapy in stroke patients (OR = 3.07; 95% CI = 1.22–7.75; p = 0.018). |
publishDate |
2020 |
dc.date.issued.fl_str_mv |
2020 |
dc.date.accessioned.fl_str_mv |
2022-10-26T04:46:40Z |
dc.type.driver.fl_str_mv |
Estrangeiro info:eu-repo/semantics/article |
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http://hdl.handle.net/10183/250278 |
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001149719 |
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http://hdl.handle.net/10183/250278 |
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eng |
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dc.relation.ispartof.pt_BR.fl_str_mv |
Frontiers in neurology. [Lausanne]. Vol. 10 (2020), 1256, 10 p. |
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info:eu-repo/semantics/openAccess |
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openAccess |
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