Predictive Risk Factors for Early Seizures in Traumatic Brain Injury

• Main Authors: Porntip Parmontree, Thara Tunthanathip, Thitima Doungngern, Malee Rojpitbulstit, Wattanachai Kulviwat, Sanguansin Ratanalert
• Format: Article
• Language: English
• Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2019-10-01
• Series: Journal of Neurosciences in Rural Practice
• Subjects: posttraumatic seizure; predictive model; risk factors; traumatic brain injury
• Online Access: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1700791

Background Early posttraumatic seizure (PTS) is a significant cause of unfavorable outcomes in traumatic brain injury (TBI). This study was aimed to investigate the incidence and determine a predictive model for early PTS. Materials and Methods A prospective cohort study of 484 TBI patients was conducted. All patients were evaluated for seizure activities within 7 days after the injury. Risk factors for early PTS were identified using univariate analysis. The candidate risk factors with p < 0.1 were selected into multivariable logistic regression analysis to identify predictors of early PTS. The fitting model and the power of discrimination with the area under the receiver operating characteristic (AUROC) curve were demonstrated. The nomogram for prediction of early PTS was developed for individuals. Results There were 27 patients (5.6%) with early PTS in this study. The final model illustrated chronic alcohol use (odds ratio [OR]: 4.06, 95% confidence interval [CI]: 1.64–10.07), epidural hematoma (OR: 3.98, 95% CI: 1.70–9.33), and Glasgow Coma Scale score 3–8 (OR: 3.78, 95% CI: 1.53–9.35) as predictors of early PTS. The AUROC curve was 0.77 (95% CI: 0.66–0.87). Conclusions The significant predictors for early PTS were chronic alcohol use, epidural hematoma, and severe TBI. Our nomogram was considered as a reliable source for prediction.