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Frequency, determinants, and effects of early seizures after thrombolysis for acute ischemic stroke: The ENCHANTED trial

Show simple item record Xu, Ying Hackett, Maree Chalmers, John Lindley, Richard Wang, Xia Li, Qiang Robinson, Thompson Arima, Hisatomi Lavados, Pablo Anderson, Craig For the ENCHANTED Study Group 2018-01-18T15:36:24Z 2018-01-18T15:36:24Z 2017
dc.identifier.citation Neurol Clin Pract. 2017 Aug;7(4):324-332 es_CL
dc.identifier.uri es_CL
dc.description.abstract BACKGROUND: Seizures after ischemic stroke have not been well-studied. We aim to determine the frequency, determinants, and significance of early seizures after thrombolysis for acute ischemic stroke. METHODS: Data are from the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED), an international, multicenter, randomized controlled trial where patients with acute ischemic stroke were randomized to low-dose (0.6 mg/kg) or standard-dose (0.9 mg/kg) IV alteplase. The protocol prespecified prospective data collection on in-hospital seizures over 7 days postrandomization. Logistic regression models were used to determine variables associated with seizures and their significance on poor outcomes of death or disability (modified Rankin scale scores 3-6), symptomatic intracerebral hemorrhage (sICH), and European Quality of Life 5-Dimensions questionnaire [EQ-5D] over 90 days. RESULTS: Data were available for 3,139 acute ischemic stroke participants, of whom 42 (1.3%) had seizures at a median 22.7 hours after the onset of symptoms. Baseline variables associated with seizures were male sex (odds ratio [OR] 2.19, 95% confidence interval [CI] 1.07-4.50), severe neurologic impairment (NIH Stroke Scale score ≥10; OR 2.16, 95% CI 1.06-4.40), and fever (OR 4.55, 95% CI 2.37-8.71). Seizures independently predicted poor recovery: death or major disability (OR 2.88, 95% CI 1.28-6.47), unfavorable ordinal shift of mRS scores (OR 1.94, 95% CI 1.10-3.39), and lower than median EQ-5D health utility index score (OR 3.50, 95% CI 1.37-8.91). There was no association of seizures with sICH in adjusted analysis. CONCLUSIONS: In thrombolysis-treated patients with acute ischemic stroke, seizures are uncommon, occur early, and predict poor recovery. es_CL
dc.format.extent 9 es_CL
dc.language.iso en_US es_CL
dc.publisher Lippincott Williams & Wilkins es_CL
dc.subject Acute ischemic stroke es_CL
dc.subject Early seizures es_CL
dc.subject Thrombolysis es_CL
dc.subject ENCHANTED trial es_CL
dc.title Frequency, determinants, and effects of early seizures after thrombolysis for acute ischemic stroke: The ENCHANTED trial es_CL
dc.type Artículo es_CL

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