(SS#V) Natus Resident/ Fellow Award for Neurotrauma (2023 Award Winner): Association of Traumatic Brain Injury and Seizure Development in the United States, During 2016-2020 a Cross-sectional Study
Saturday, April 22, 2023
2:12pm – 2:20pm PST
Location: Los Angeles Convention Center, Theater- 411
Resident University of Texas Health Science Center San Antonio San Antonio, Texas, United States
Disclosure(s):
Daniel Smerin, MD: No financial relationships to disclose
Introduction: Patients with Traumatic Brain Injury (TBI) are at risk of developing Seizure (Sz) during admission. This study aimed to determine the association between TBI and Sz based on the different sub-types of TBI and to evaluate the outcome of this population.
Methods: This is a cross-sectional study of TBI subjects from 2016-2020 in the United States collected from Nationwide Inpatient Sample (NIS). Patients were evaluated for demographics, sub-types of TBI, and comorbidities. Cohort was dichotomized to the presence or absence of new-onset Sz during admission. R-Studio statistical software was used, with a significant p< 0.05.
Results: For 5 years study, there were 1,033,540 TBI, of which 6% developed Sz. Most TBIs were white (71.5%), males (59.4%) with a mean age of 64.9( +/- 20) y/o. Those who developed Sz were significantly younger (63 vs. 65 y/o, p< 0.001), male (62%, p< 0.001), had longer hospital stays(LOS), ( 8.7 vs 6.8 d, p< 0.001), paradoxically had less mortality( 7.4% vs. 8.2%, p=0.001), and had significantly more hospital charges( $113,484.9 vs. $97,204.2, p< 0.001). In multivariate regression, between sub-types of TBI, Subdural Hemorrhage (SDH) was the only one associated with higher Sz (OR. 1.52, 95%CI [ 1.46-1.58], p< 0.001). Sz was associated with younger age ( OR 0.77, 95% CI[ 0.75-0.79],p < 0.001) , lower mortality (OR. 0.92, 95%CI [ 0.86-0.98], p=0.017) but a higher length of stay (OR 1.58. 95% CI [1.40-1.77],p < 0.001). When analyzing the co-morbidities, liver disease (OR.1.52, 95% CI [ 1.4-1.6], p< 0.001), hypertension (OR, 1.36, 95% CI[ 1.3-1.4], p< 0.001) and black race (OR1.36, 95%CI[ 1.3-1.44], p< 0.001) had the highest impact on developing Sz.
Conclusion : Our data show that the incidence of Sz in TBI is 6.6%, and it happens 50% more in SDH. Sz is associated with younger age, higher hospital LOS, higher charges, and paradoxically, less in-hospital mortality.
