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Tytuł:
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Association of Posttraumatic Epilepsy With 1-Year Outcomes After Traumatic Brain Injury.
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Autorzy:
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Burke J; Department of Neurosurgery, University of California, San Francisco.; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California.
Gugger J; Department of Neurology, University of Pennsylvania, Philadelphia.
Ding K; Department of Neurology, University of Texas Southwestern Medical Center, Dallas.
Kim JA; Department of Neurology, Yale University School of Medicine, New Haven, Connecticut.
Foreman B; Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio.
Yue JK; Department of Neurosurgery, University of California, San Francisco.; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California.
Puccio AM; Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Yuh EL; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California.; Department of Radiology, University of California. San Francisco.
Sun X; Department of Family Medicine and Public Health, University of California, San Diego.
Rabinowitz M; Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Vassar MJ; Department of Neurosurgery, University of California, San Francisco.; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California.
Taylor SR; Department of Neurosurgery, University of California, San Francisco.; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California.
Winkler EA; Department of Neurosurgery, University of California, San Francisco.; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California.
Deng H; Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
McCrea M; Department of Neurosurgery, Medical College of Wisconsin, Milwaukee.
Stein MB; Department of Psychiatry and Public Health, University of California, San Diego.
Robertson CS; Departments of Neurosurgery and Critical Care, Baylor College of Medicine, Houston, Texas.
Levin HS; Departments of Neurosurgery and Neurology, Baylor College of Medicine, Houston, Texas.
Dikmen S; Department of Rehabilitation Medicine, University of Washington, Seattle.
Temkin NR; Department of Neurosurgery, University of Washington, Seattle.; Departments of Biostatistics, University of Washington, Seattle.
Barber J; Departments of Biostatistics, University of Washington, Seattle.
Giacino JT; Rehabilitation Neuropsychology, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts.
Mukherjee P; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California.; Department of Radiology, University of California. San Francisco.
Wang KKW; Department of Psychiatry and Neurosciences, McKnight Brain Institute, University of Florida, Gainesville.
Okonkwo DO; Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Markowitz AJ; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California.
Jain S; Department of Family Medicine and Public Health, University of California, San Diego.
Lowenstein D; Department of Neurology, University of California, San Francisco.
Manley GT; Department of Neurosurgery, University of California, San Francisco.; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California.
Diaz-Arrastia R; Department of Neurology, University of Pennsylvania, Philadelphia.
Badjatia N; University of Maryland, Baltimore.
Duhaime AC; MassGeneral Hospital for Children, Boston, Massachusetts.
Feeser VR; Virginia Commonwealth University, Richmond.
Gaudette E; University of Toronto, Toronto, Canada.
Gopinath S; Baylor College of Medicine, Houston, Texas.
Keene CD; University of Washington, Seattle.
Korley FK; University of Michigan, Ann Arbor.
Madden C; UT Southwestern Medical Center, Dallas, Texas.
Merchant R; Virginia Commonwealth University, Richmond.
Schnyer D; The University of Texas at Austin, Austin.
Zafonte R; Harvard Medical School, Boson, Massachusetts.
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Corporate Authors:
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TRACK-TBI Investigators
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Źródło:
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JAMA network open [JAMA Netw Open] 2021 Dec 01; Vol. 4 (12), pp. e2140191. Date of Electronic Publication: 2021 Dec 01.
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Typ publikacji:
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Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.
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Język:
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English
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Imprint Name(s):
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Original Publication: Chicago, IL : American Medical Association, [2018]-
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MeSH Terms:
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Brain Injuries, Traumatic/*complications
Epilepsy, Post-Traumatic/*epidemiology
Adult ; Cohort Studies ; Epilepsy, Post-Traumatic/etiology ; Female ; Glasgow Coma Scale ; Humans ; Incidence ; Male ; Prospective Studies ; Risk Factors ; Self Report ; Surveys and Questionnaires ; Trauma Centers ; United States/epidemiology
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References:
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Grant Information:
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U54 NS115322 United States NS NINDS NIH HHS; UL1 TR001863 United States TR NCATS NIH HHS
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Entry Date(s):
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Date Created: 20211229 Date Completed: 20220113 Latest Revision: 20220716
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Update Code:
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20240104
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PubMed Central ID:
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PMC8717106
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DOI:
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10.1001/jamanetworkopen.2021.40191
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PMID:
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34964854
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Importance: Posttraumatic epilepsy (PTE) is a recognized sequela of traumatic brain injury (TBI), but the long-term outcomes associated with PTE independent of injury severity are not precisely known.
Objective: To determine the incidence, risk factors, and association with functional outcomes and self-reported somatic, cognitive, and psychological concerns of self-reported PTE in a large, prospectively collected TBI cohort.
Design, Setting, and Participants: This multicenter, prospective cohort study was conducted as part of the Transforming Research and Clinical Knowledge in Traumatic Brain Injury study and identified patients presenting with TBI to 1 of 18 participating level 1 US trauma centers from February 2014 to July 2018. Patients with TBI, extracranial orthopedic injuries (orthopedic controls), and individuals without reported injuries (eg, friends and family of participants; hereafter friend controls) were prospectively followed for 12 months. Data were analyzed from January 2020 to April 2021.
Exposure: Demographic, imaging, and clinical information was collected according to TBI Common Data Elements. Incidence of self-reported PTE was assessed using the National Institute of Neurological Disorders and Stroke Epilepsy Screening Questionnaire (NINDS-ESQ).
Main Outcomes and Measures: Primary outcomes included Glasgow Outcome Scale Extended, Rivermead Cognitive Metric (RCM; derived from the Rivermead Post Concussion Symptoms Questionnaire), and the Brief Symptom Inventory-18 (BSI).
Results: Of 3296 participants identified as part of the study, 3044 met inclusion criteria, and 1885 participants (mean [SD] age, 41.3 [17.1] years; 1241 [65.8%] men and 644 [34.2%] women) had follow-up information at 12 months, including 1493 patients with TBI; 182 orthopedic controls, 210 uninjured friend controls; 41 patients with TBI (2.8%) and no controls had positive screening results for PTE. Compared with a negative screening result for PTE, having a positive screening result for PTE was associated with presenting Glasgow Coma Scale score (8.1 [4.8] vs.13.5 [3.3]; P < .001) as well as with anomalous acute head imaging findings (risk ratio, 6.42 [95% CI, 2.71-15.22]). After controlling for age, initial Glasgow Coma Scale score, and imaging findings, compared with patients with TBI and without PTE, patients with TBI and with positive PTE screening results had significantly lower Glasgow Outcome Scale Extended scores (mean [SD], 6.1 [1.7] vs 4.7 [1.5]; P < .001), higher BSI scores (mean [SD], 50.2 [10.7] vs 58.6 [10.8]; P = .02), and higher RCM scores (mean [SD], 3.1 [2.6] vs 5.3 [1.9]; P = .002) at 12 months.
Conclusions and Relevance: In this cohort study, the incidence of self-reported PTE after TBI was found to be 2.8% and was independently associated with unfavorable outcomes. These findings highlight the need for effective antiepileptogenic therapies after TBI.
