Increasing Risk of Dementia Among Patients with Subsequent Epilepsy Within 2 Years Post-Traumatic Brain Injury: A Population‐Based Case-Control Study

Shu-Fen Chu, Kuo-Hsing Liao, Li Wei
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Abstract

Background Although the association between neurodegenerative diseases, such as dementia, and traumatic brain injury (TBI) has long been known, the association between dementia and TBI with epilepsy has been controversial. Aim This data-driven population-based study is designed to investigate the association between dementia and epilepsy after TBI within a 2-year period. Methods This case-control cohort study was conducted using the Longitudinal Health Insurance Database 2000 (LHID2000). We included 784 individuals ambulatory or hospitalized for TBI with epilepsy from 2001 to 2011, compared with 2992 patients with TBI without epilepsy who were matched for characteristics including sex, age, and healthcare resource use index date. Every participant was followed up for 5 years to ascertain any dementia development. Data were stratified and analyzed using the Cox proportional hazards regression. Results Through the 5-year follow-up period, 39 patients (5.21%) with TBI with epilepsy and 55 (1.53%) with TBI without epilepsy developed dementia. TBI with epilepsy was independently associated with a >3.03 times risk of dementia after correcting for age, sex, and comorbidities. Conclusion These findings suggest an increased risk of dementia in patients with TBI with epilepsy. Our research recommends that individuals with TBI and epilepsy be monitored more intensively.
脑外伤后两年内继发癫痫的患者患痴呆症的风险增加:基于人群的病例对照研究
背景 虽然痴呆症等神经退行性疾病与创伤性脑损伤(TBI)之间的关联早已为人所知,但痴呆症和创伤性脑损伤与癫痫之间的关联却一直存在争议。目的 这项以数据为驱动的人群研究旨在调查两年内创伤性脑损伤后痴呆与癫痫之间的关联。方法 这项病例对照队列研究是利用纵向健康保险数据库 2000(LHID2000)进行的。我们纳入了 784 名在 2001 年至 2011 年期间因创伤性脑损伤住院或卧床并伴有癫痫的患者,并与 2992 名创伤性脑损伤但未伴有癫痫的患者进行了比较,这些患者的性别、年龄和医疗资源使用指数日期等特征与这些患者相匹配。对每位参与者进行了为期 5 年的随访,以确定是否出现痴呆症。采用考克斯比例危险回归法对数据进行分层和分析。结果 在5年的随访期间,有39名(5.21%)伴有癫痫的创伤性脑损伤患者和55名(1.53%)未伴有癫痫的创伤性脑损伤患者患上了痴呆症。在对年龄、性别和合并症进行校正后,伴有癫痫的创伤性脑损伤与大于 3.03 倍的痴呆风险独立相关。结论 这些研究结果表明,伴有癫痫的创伤性脑损伤患者患痴呆症的风险增加。我们的研究建议对患有创伤性脑损伤和癫痫的患者加强监测。
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