% 0期刊文章%一个Arka马修·皮斯% n Mallela %细语一个大卫·o·乔纳森•埃尔默% %一个Lori快门% Niravkumar巴% Jorge Gonzalez-Martinez %詹姆斯·f·可以见到效果% T创伤后癫痫协会与长期患有严重的创伤性脑损伤的功能结果% D R 10.1212 / WNL 2023%。0000000000207183 % J半岛投注体育官网神经病学% P e1967-e1975 % V 100% N 19% X背景和目标近三分之一的患者严重创伤性脑损伤(TBI)发展创伤后癫痫(PTE)。PTE的关系和长期的结果是未知的。我们测试是否在控制了损伤严重程度和年龄,PTE是严重创伤性脑损伤后功能较差的结果。方法:我们进行了回顾性分析治疗的潜在严重创伤性脑损伤患者的数据库从2002年到2018年在一个1级创伤中心。格拉斯哥预后量表(GOS)收集在3、6、12、24个月postinjury。我们使用重复测量逻辑回归预测率高,一分为二,有利(GOS 4 - 5)和不利(GOS 1 - 3),和一个单独的物流模型预测死亡率2年。我们使用国际任务定义的预测预后的临床试验和分析创伤性脑损伤(影响)基本模型(即。、年龄、瞳孔反应,GCS电动机分数),PTE的地位,和时间。392患者幸存下来放电的结果,98年(25%)发达PTE。患者有利的结果的比例在3个月那些没有差异,没有PTE(23%(95%可信区间[CI]: 15% - -34%)和32% (95% CI: 27% - -39%);6点p = 0.11),但显著降低(33% (95% CI: 23% - -44%)与46%;(95% CI: 39% - -52%) p = 0.03), 12 (41% (95% CI: 30% - -52%)和54% (95% CI: 47% - -61%); p = 0.03), and 24 months (40% [95% CI: 47%–61%] vs 55% [95% CI: 47%–63%]; p = 0.04). This was driven by higher rates of GOS 2 (vegetative) and 3 (severe disability) outcomes in the PTE group. By 2 years, the incidence of GOS 2 or 3 was double in the PTE group (46% [95% CI: 34%–59%]) compared with that in the non-PTE group (21% [95% CI: 16%–28%]; p < 0.001), while mortality was similar (14% [95% CI: 7%–25%] vs 23% [95% CI: 17%–30%]; p = 0.28). In multivariate analysis, patients with PTE had lower odds of favorable outcome (odds radio [OR] 0.1; 95% CI: 0.1–0.4; p < 0.001), but not mortality (OR 0.9; 95% CI: 0.1–1.9; p = 0.46).Discussion Posttraumatic epilepsy is associated with impaired recovery from severe TBI and poor functional outcomes. Early screening and treatment of PTE may improve patient outcomes.CI=confidence interval; DHC=decompressive hemicraniectomy; GCS=Glasgow Coma Scale; GOS=Glasgow Outcome Scale; IMPACT=International Mission for Prognosis and Analysis of Clinical Trials in TBI; OR=odds radio; PTE=posttraumatic epilepsy; TBI=traumatic brain injury %U //www.ebmtp.com/content/neurology/100/19/e1967.full.pdf
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