RT杂志文章SR电子T1危险因素和脑脓肿后癫痫的预后:一项全国人群为基础的队列研究首页10.1212 / WNL.0000000000206866A1 Jacob Bodilsen A1 Lærke Storgaard Duerlund A1 Theis Mariager A1 Christian Thomas Brandt A1 Lothar Wiese A1 Pelle Trier Petersen A1 Lykke Larsen A1 Birgitte Rønde Hansen A1 Lars Haukali Omland A1 Malte Mose Tetens A1 Rasmus Langelund Jørgensen A1 Steffen Leth A1 Henrik Nielsen YR 2023 UL http://n.首页neurology.org/content/early/2023/02/21/WNL.0000000000206866.abstract AB背景和目标:癫痫在脑脓肿患者中很常见，但危险因素和预后尚不明确。这项研究调查了脑脓肿幸存者癫痫的危险因素和相关预后。方法:在全国范围内，使用基于人群的医疗保健登记，计算1982年至2016年30天脑脓肿幸存者中癫痫的累积发病率和原因特异性调整危险率比(adj. HRRs)， 95%置信区间(ci)。通过回顾2007年至2016年住院患者的病历，丰富了数据中的临床细节。将癫痫作为时间依赖变量，对调整后的死亡率比率(MRRs)进行检查。结果:该研究包括1179名30天脑脓肿幸存者，其中323人(27%)在中位数为0.76年后发生新发癫痫(四分位数范围[IQR] 0.24-2.41)。因脑脓肿入院时，癫痫患者的中位年龄为46岁(IQR 32-59岁)，而无癫痫患者的中位年龄为52岁(IQR 33-64岁)。 The proportion of females was similar in patients with and without epilepsy (37%). Adj. HRRs for epilepsy were 2.44 (95% CI 1.89-3.15) for aspiration or excision of brain abscess, 2.37 (1.56-3.60) for alcohol abuse, 1.75 (1.27-2.40) for previous neurosurgery or head trauma, 1.62 (1.17-2.25) for stroke, and 1.55 (1.04-2.32) for age group 20-39 years. Cumulative incidences were increased in patients with alcohol abuse (52% vs 31%), aspiration or excision of brain abscess (41% vs. 20%), previous neurosurgery or head trauma (41% vs. 31%), and stroke (46% vs. 31%). Analysis using clinical details from medical record review of patients from 2007 through 2016 demonstrated adj. HRRs of 3.70 (2.24-6.13) for seizures at admission for brain abscess and 1.80 (1.04-3.11) for frontal lobe abscess. In contrast, adj. HRR was 0.42 (0.21-0.86) for occipital lobe abscess.Using the entire registry-based cohort, patients with epilepsy had an adj. MRR of 1.26 (1.01-1.57).Discussion: Important risk factors for epilepsy were seizures during admission for brain abscess, neurosurgery, alcoholism, frontal lobe abscess, and stroke. Epilepsy was associated with increased mortality. Anti-epileptic treatment may be guided by individual risk profiles and specialized follow-up is highlighted by increased mortality in survivors with epilepsy.