Associations between post-traumatic seizures, antiseizure medication, and duration of post-traumatic amnesia: a retrospective cohort analysis.

IF 3.7 2区医学 Q1 REHABILITATION

Archives of physical medicine and rehabilitation Pub Date : 2025-09-30 DOI:10.1016/j.apmr.2025.09.020

Sergiu Albu, Oyku Arslantas, Hatice Kumru

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引用次数: 0

Abstract

Objectives: To evaluate the relationship between posttraumatic seizure (PTS) and anti-seizure medications (ASMs) use with post-traumatic amnesia (PTA) duration.

Design: Retrospective study.

Setting: Guttmann Institute, Neurorehabilitation Hospital (Badalona, Barcelona, Spain).

Participants: Patients with PTA following traumatic brain injury (TBI) admitted for rehabilitation between February 2002 and May 2024.

Interventions: none.

Main outcome measures: Age, gender, Glasgow Coma Scale (GCS) score, Galveston Orientation and Amnesia Test (GOAT) scores at admission and discharge, presence of PTS and ASM use, and PTA duration (days from TBI to PTA emergence). Group comparisons were conducted between patients with or without PTS and ASM use to identify differences in clinically relevant variables related with PTA duration. Cox proportional-hazards models were conducted to estimate PTA duration.

Results: A total of 352 patients (80.4% male; median age: 39.54 years) were distributed into four groups: Treatment-PTS (N=64, ASM for PTS), Prophylactic-ASM (N=46, ASM to prevent PTS), Behavior/Pain-ASM (N=160, ASM for behavioral impairment or neuropathic pain but no PTS), and noASM (N=82). Median PTA duration was shortest in noASM (59.1 days [IQR: 48.6-89.7]) compared to Treatment-PTS (74.7 [IQR: 55.5-111.5]), Prophylactic-ASM (84.5 [IQR: 59.0-102.2]) and Behavior/Pain-ASM (78.1 [56.6-102.5]) (p=0.02). Older age (HR: 0.98; 95% CI: 0.98 - 0.99), lower admission GOAT scores (HR: 1.02; 95% CI: 1.02 - 1.03), and being on Treatment for PTS as compared to noASM (HR:0.58; 95 % CI: 0.38-0.88) or Behavior/Pain-ASM (HR: 0.61; 95 % CI 0.42-0.89) had significant negative association with the PTA duration.

Conclusions: ASM use, older age and lower GOAT score are associated with longer PTA duration. The high use rates of ASMs in TBI patients extending beyond those with PTS underscores the importance of careful evaluation of ASM use to optimize outcomes in TBI patients with PTA.

查看原文本刊更多论文

创伤后癫痫发作、抗癫痫药物和创伤后健忘症持续时间之间的关系：一项回顾性队列分析。

目的：评价创伤后癫痫发作（PTS）和抗癫痫药物（asm）使用与创伤后遗忘（PTA）持续时间的关系。设计：回顾性研究。环境：古特曼研究所，神经康复医院（巴达洛纳，巴塞罗那，西班牙）。参与者：2002年2月至2024年5月期间接受康复治疗的创伤性脑损伤（TBI）后PTA患者。干预措施:没有。主要结局指标：年龄、性别、格拉斯哥昏迷量表（GCS）评分、入院和出院时加尔维斯顿定向和失忆测试（GOAT）评分、PTS和ASM使用情况、PTA持续时间（从TBI到PTA出现的天数）。组间比较采用或不采用PTS和ASM的患者，以确定与PTA持续时间相关的临床相关变量的差异。采用Cox比例风险模型估计PTA持续时间。结果：352例患者（男性占80.4%，中位年龄39.54岁）分为4组：Treatment-PTS组（64例，为PTS的ASM）、preventive -ASM组（46例，为预防PTS的ASM）、Behavior/ pain -ASM组（160例，为行为障碍或神经性疼痛的ASM，无PTS）和noASM组（82例）。与治疗- pts组（74.7 [IQR: 55.5-111.5]）、预防- asm组（84.5 [IQR: 59.0-102.2]）和行为/疼痛- asm组（78.1[56.6-102.5]）相比，noASM组的PTA持续时间中位数最短（59.1天[IQR: 48.6-89.7]）（p=0.02）。老年(人力资源:0.98;95%置信区间:0.98 - 0.99),录取山羊的得分越低(人力资源:1.02;95%置信区间CI: 1.02 —— 1.03),并在治疗分相比noASM(人力资源:0.58;95 % CI: 0.38 - -0.88)或行为/ Pain-ASM(人力资源:0.61;95年 % CI 0.42 - -0.89)有重大的负面协会PTA持续时间。结论：使用ASM、年龄较大、GOAT评分较低与PTA持续时间较长相关。在TBI患者中，ASM的高使用率超出了PTS患者，这强调了仔细评估ASM使用以优化PTA TBI患者预后的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of physical medicine and rehabilitation 医学-康复医学

CiteScore

6.20

自引率

4.70%

发文量

495

审稿时长

38 days

期刊介绍： The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities. Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.