Erik Lindgren, Liqi Shu, Naaem Simaan, Katarzyna Krzywicka, Maria A de Winter, Mayte Sánchez van Kammen, Jeremy Molad, Piers Klein, Hen Hallevi, Rani Barnea, Mirjam R Heldner, Sini Hiltunen, Diana Aguiar de Sousa, José M Ferro, Antonio Arauz, Jukka Putaala, Marcel Arnold, Thanh N Nguyen, Christoph Stretz, Turgut Tatlisumak, Katarina Jood, Shadi Yaghi, Ronen R Leker, Jonathan M Coutinho, Maryam Mansour, Patrícia Canhão, Esme Ekizoglu, Miguel Rodrigues, Elisa M Silva, Carlos Garcia-Esperon, Valentina Arnao, Shorooq Aladin, Rom Mendel, Paolo Aridon, Mine Sezgin, Andrey Alasheev, Andrey Smolkin, Daniel Guisado-Alonso, Nilufer Yesilot, Miguel A Barboza, Masoud Ghiasian, Suzanne M Silvis, Ton Fang, James E Siegler, Teddy Wu, Duncan Wilson, Syed Daniyal Asad, Sami Al Kasab, Eyad Almallouhi, Jennifer Frontera, Aaron Rothstein, Ekaterina Bakradze, Setareh Salehi Omran, Nils Henninger, Lindsey Kuohn, Adeel Zubair, Richa Sharma, Deborah Kerrigan, Yasmin Aziz, Eva Mistry, Susanna M Zuurbier
{"title":"预测脑静脉血栓后癫痫的临床评分的开发与验证","authors":"Erik Lindgren, Liqi Shu, Naaem Simaan, Katarzyna Krzywicka, Maria A de Winter, Mayte Sánchez van Kammen, Jeremy Molad, Piers Klein, Hen Hallevi, Rani Barnea, Mirjam R Heldner, Sini Hiltunen, Diana Aguiar de Sousa, José M Ferro, Antonio Arauz, Jukka Putaala, Marcel Arnold, Thanh N Nguyen, Christoph Stretz, Turgut Tatlisumak, Katarina Jood, Shadi Yaghi, Ronen R Leker, Jonathan M Coutinho, Maryam Mansour, Patrícia Canhão, Esme Ekizoglu, Miguel Rodrigues, Elisa M Silva, Carlos Garcia-Esperon, Valentina Arnao, Shorooq Aladin, Rom Mendel, Paolo Aridon, Mine Sezgin, Andrey Alasheev, Andrey Smolkin, Daniel Guisado-Alonso, Nilufer Yesilot, Miguel A Barboza, Masoud Ghiasian, Suzanne M Silvis, Ton Fang, James E Siegler, Teddy Wu, Duncan Wilson, Syed Daniyal Asad, Sami Al Kasab, Eyad Almallouhi, Jennifer Frontera, Aaron Rothstein, Ekaterina Bakradze, Setareh Salehi Omran, Nils Henninger, Lindsey Kuohn, Adeel Zubair, Richa Sharma, Deborah Kerrigan, Yasmin Aziz, Eva Mistry, Susanna M Zuurbier","doi":"10.1001/jamaneurol.2024.3481","DOIUrl":null,"url":null,"abstract":"<p><strong>Importance: </strong>One of 10 patients develop epilepsy in the late phase after cerebral venous thrombosis (CVT) diagnosis but predicting the individual risk is difficult.</p><p><strong>Objective: </strong>To develop and externally validate a prognostic score to estimate the individual risk of post-CVT epilepsy.</p><p><strong>Design, setting, and participants: </strong>This observational cohort study included both retrospective and prospective patients enrolled from 1994 through 2022. For development of the DIAS3 score, data from the International CVT Consortium (n = 1128), a large international hospital-based multicenter CVT cohort, were used. For validation, data from 2 independent multicenter cohorts, the ACTION-CVT (n = 543) and the Israel CVT study (n = 556), were used. Of 2937 eligible, consecutively enrolled adult patients with radiologically verified CVT, 710 patients with a history of epilepsy prior to CVT, follow-up less than 8 days, and missing late seizure status were excluded.</p><p><strong>Exposure: </strong>The prediction score (DIAS3) was developed based on available literature and clinical plausibility and consisted of 6 readily available clinical variables collected during the acute phase: decompressive hemicraniectomy, intracerebral hemorrhage at presentation, age, seizure(s) in the acute phase (excluding status epilepticus), status epilepticus in the acute phase, and subdural hematoma at presentation.</p><p><strong>Main outcome and measure: </strong>Time to a first late seizure, defined as occurring more than 7 days after diagnosis of CVT.</p><p><strong>Results: </strong>Of 1128 patients included in the derivation cohort (median age, 41 [IQR, 30-53] years; 805 women [71%]), 128 (11%) developed post-CVT epilepsy during a median follow-up of 12 (IQR, 3-26) months. According to the DIAS3 score, the predicted 1-year and 3-year risk of epilepsy in individual patients ranged from 7% to 68% and 10% to 83%, respectively. Internal and external validation showed adequate discrimination in the derivation cohort (1 year and 3 years: C statistic, 0.74; 95% CI, 0.70-0.79) and the 2 independent validation cohorts, (ACTION-CVT) 1 year: C statistic, 0.76; 95% CI, 0.67-0.84; 3 years: C statistic, 0.77; 95% CI, 0.66-0.84; and Israel CVT study 1 year: C statistic, 0.80; 95% CI, 0.75-0.86. Calibration plots indicated adequate agreement between predicted and observed risks.</p><p><strong>Conclusions and relevance: </strong>The DIAS3 score (freely available online) is a simple tool that can help predict the risk of post-CVT epilepsy in individual patients. The model can improve opportunities for personalized medicine and may aid in decision-making regarding antiseizure medication, patient counseling, and facilitation of research on epileptogenesis in CVT.</p>","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"1274-1283"},"PeriodicalIF":20.4000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11581563/pdf/","citationCount":"0","resultStr":"{\"title\":\"Development and Validation of a Clinical Score to Predict Epilepsy After Cerebral Venous Thrombosis.\",\"authors\":\"Erik Lindgren, Liqi Shu, Naaem Simaan, Katarzyna Krzywicka, Maria A de Winter, Mayte Sánchez van Kammen, Jeremy Molad, Piers Klein, Hen Hallevi, Rani Barnea, Mirjam R Heldner, Sini Hiltunen, Diana Aguiar de Sousa, José M Ferro, Antonio Arauz, Jukka Putaala, Marcel Arnold, Thanh N Nguyen, Christoph Stretz, Turgut Tatlisumak, Katarina Jood, Shadi Yaghi, Ronen R Leker, Jonathan M Coutinho, Maryam Mansour, Patrícia Canhão, Esme Ekizoglu, Miguel Rodrigues, Elisa M Silva, Carlos Garcia-Esperon, Valentina Arnao, Shorooq Aladin, Rom Mendel, Paolo Aridon, Mine Sezgin, Andrey Alasheev, Andrey Smolkin, Daniel Guisado-Alonso, Nilufer Yesilot, Miguel A Barboza, Masoud Ghiasian, Suzanne M Silvis, Ton Fang, James E Siegler, Teddy Wu, Duncan Wilson, Syed Daniyal Asad, Sami Al Kasab, Eyad Almallouhi, Jennifer Frontera, Aaron Rothstein, Ekaterina Bakradze, Setareh Salehi Omran, Nils Henninger, Lindsey Kuohn, Adeel Zubair, Richa Sharma, Deborah Kerrigan, Yasmin Aziz, Eva Mistry, Susanna M Zuurbier\",\"doi\":\"10.1001/jamaneurol.2024.3481\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Importance: </strong>One of 10 patients develop epilepsy in the late phase after cerebral venous thrombosis (CVT) diagnosis but predicting the individual risk is difficult.</p><p><strong>Objective: </strong>To develop and externally validate a prognostic score to estimate the individual risk of post-CVT epilepsy.</p><p><strong>Design, setting, and participants: </strong>This observational cohort study included both retrospective and prospective patients enrolled from 1994 through 2022. For development of the DIAS3 score, data from the International CVT Consortium (n = 1128), a large international hospital-based multicenter CVT cohort, were used. For validation, data from 2 independent multicenter cohorts, the ACTION-CVT (n = 543) and the Israel CVT study (n = 556), were used. Of 2937 eligible, consecutively enrolled adult patients with radiologically verified CVT, 710 patients with a history of epilepsy prior to CVT, follow-up less than 8 days, and missing late seizure status were excluded.</p><p><strong>Exposure: </strong>The prediction score (DIAS3) was developed based on available literature and clinical plausibility and consisted of 6 readily available clinical variables collected during the acute phase: decompressive hemicraniectomy, intracerebral hemorrhage at presentation, age, seizure(s) in the acute phase (excluding status epilepticus), status epilepticus in the acute phase, and subdural hematoma at presentation.</p><p><strong>Main outcome and measure: </strong>Time to a first late seizure, defined as occurring more than 7 days after diagnosis of CVT.</p><p><strong>Results: </strong>Of 1128 patients included in the derivation cohort (median age, 41 [IQR, 30-53] years; 805 women [71%]), 128 (11%) developed post-CVT epilepsy during a median follow-up of 12 (IQR, 3-26) months. According to the DIAS3 score, the predicted 1-year and 3-year risk of epilepsy in individual patients ranged from 7% to 68% and 10% to 83%, respectively. Internal and external validation showed adequate discrimination in the derivation cohort (1 year and 3 years: C statistic, 0.74; 95% CI, 0.70-0.79) and the 2 independent validation cohorts, (ACTION-CVT) 1 year: C statistic, 0.76; 95% CI, 0.67-0.84; 3 years: C statistic, 0.77; 95% CI, 0.66-0.84; and Israel CVT study 1 year: C statistic, 0.80; 95% CI, 0.75-0.86. Calibration plots indicated adequate agreement between predicted and observed risks.</p><p><strong>Conclusions and relevance: </strong>The DIAS3 score (freely available online) is a simple tool that can help predict the risk of post-CVT epilepsy in individual patients. The model can improve opportunities for personalized medicine and may aid in decision-making regarding antiseizure medication, patient counseling, and facilitation of research on epileptogenesis in CVT.</p>\",\"PeriodicalId\":14677,\"journal\":{\"name\":\"JAMA neurology\",\"volume\":\" \",\"pages\":\"1274-1283\"},\"PeriodicalIF\":20.4000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11581563/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JAMA neurology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1001/jamaneurol.2024.3481\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JAMA neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1001/jamaneurol.2024.3481","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Development and Validation of a Clinical Score to Predict Epilepsy After Cerebral Venous Thrombosis.
Importance: One of 10 patients develop epilepsy in the late phase after cerebral venous thrombosis (CVT) diagnosis but predicting the individual risk is difficult.
Objective: To develop and externally validate a prognostic score to estimate the individual risk of post-CVT epilepsy.
Design, setting, and participants: This observational cohort study included both retrospective and prospective patients enrolled from 1994 through 2022. For development of the DIAS3 score, data from the International CVT Consortium (n = 1128), a large international hospital-based multicenter CVT cohort, were used. For validation, data from 2 independent multicenter cohorts, the ACTION-CVT (n = 543) and the Israel CVT study (n = 556), were used. Of 2937 eligible, consecutively enrolled adult patients with radiologically verified CVT, 710 patients with a history of epilepsy prior to CVT, follow-up less than 8 days, and missing late seizure status were excluded.
Exposure: The prediction score (DIAS3) was developed based on available literature and clinical plausibility and consisted of 6 readily available clinical variables collected during the acute phase: decompressive hemicraniectomy, intracerebral hemorrhage at presentation, age, seizure(s) in the acute phase (excluding status epilepticus), status epilepticus in the acute phase, and subdural hematoma at presentation.
Main outcome and measure: Time to a first late seizure, defined as occurring more than 7 days after diagnosis of CVT.
Results: Of 1128 patients included in the derivation cohort (median age, 41 [IQR, 30-53] years; 805 women [71%]), 128 (11%) developed post-CVT epilepsy during a median follow-up of 12 (IQR, 3-26) months. According to the DIAS3 score, the predicted 1-year and 3-year risk of epilepsy in individual patients ranged from 7% to 68% and 10% to 83%, respectively. Internal and external validation showed adequate discrimination in the derivation cohort (1 year and 3 years: C statistic, 0.74; 95% CI, 0.70-0.79) and the 2 independent validation cohorts, (ACTION-CVT) 1 year: C statistic, 0.76; 95% CI, 0.67-0.84; 3 years: C statistic, 0.77; 95% CI, 0.66-0.84; and Israel CVT study 1 year: C statistic, 0.80; 95% CI, 0.75-0.86. Calibration plots indicated adequate agreement between predicted and observed risks.
Conclusions and relevance: The DIAS3 score (freely available online) is a simple tool that can help predict the risk of post-CVT epilepsy in individual patients. The model can improve opportunities for personalized medicine and may aid in decision-making regarding antiseizure medication, patient counseling, and facilitation of research on epileptogenesis in CVT.
期刊介绍：
JAMA Neurology is an international peer-reviewed journal for physicians caring for people with neurologic disorders and those interested in the structure and function of the normal and diseased nervous system. The Archives of Neurology & Psychiatry began publication in 1919 and, in 1959, became 2 separate journals: Archives of Neurology and Archives of General Psychiatry. In 2013, their names changed to JAMA Neurology and JAMA Psychiatry, respectively. JAMA Neurology is a member of the JAMA Network, a consortium of peer-reviewed, general medical and specialty publications.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
