Institutional Repository UDD

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

Show simple item record

dc.contributor.author Xu, Ying
dc.contributor.author Hackett, Maree
dc.contributor.author Chalmers, John
dc.contributor.author Lindley, Richard
dc.contributor.author Wang, Xia
dc.contributor.author Li, Qiang
dc.contributor.author Robinson, Thompson
dc.contributor.author Arima, Hisatomi
dc.contributor.author Lavados, Pablo
dc.contributor.author Anderson, Craig
dc.contributor.author For the ENCHANTED Study Group
dc.date.accessioned 2018-01-18T15:36:24Z
dc.date.available 2018-01-18T15:36:24Z
dc.date.issued 2017
dc.identifier.citation Neurol Clin Pract. 2017 Aug;7(4):324-332 es_CL
dc.identifier.uri http://dx.doi.org/10.1212/CPJ.0000000000000384 es_CL
dc.identifier.uri http://hdl.handle.net/11447/1919
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


Files in this item

This item appears in the following Collection(s)

Show simple item record

Search DSpace


Browse

My Account