title: Risk of epilepsy after traumatic brain injury: a retrospective population-based cohort study.
abstract: OBJECTIVE
  To investigate the associated risk of epilepsy after traumatic brain injury (TBI) in a population-based retrospective cohort study.
  
  
  METHODS
  Using Taiwan's National Health Insurance Research Database of reimbursement claims, we conducted a retrospective cohort study of 19 336 TBI patients and 540 322 non-TBI participants aged ≥15 years as reference group. Data on newly developed epilepsy after TBI with 5-8 years' follow-up during 2000 to 2008 were collected. HRs and 95% CIs for the risk of epilepsy associated with TBI were analysed with multivariate Cox proportional hazards regressions.
  
  
  RESULTS
  Compared with the non-TBI cohort, the adjusted HRs of developing epilepsy among TBI patients with skull fracture, severe or mild brain injury were 10.6 (95% CI 7.14 to 15.8), 5.05 (95% CI 4.40 to 5.79) and 3.02 (95% CI 2.42 to 3.77), respectively. During follow-up, men exhibited higher risks of post-TBI epilepsy. Patients who had mixed types of cerebral haemorrhage were at the highest risk of epilepsy compared with the non-TBI cohort (HR 7.83, 95% CI 4.69 to 13.0). The risk of post-TBI epilepsy was highest within the first year after TBI (HR 38.2, 95% CI 21.7 to 67.0).
  
  
  CONCLUSIONS
  The risk of epilepsy after TBI varied by patient gender, age, latent interval and complexity of TBI. Integrated care for early identification and treatment of post-trauma epilepsy were crucial for TBI patients.
authors.affiliation: Department of Anesthesiology, Taipei Medical University Hospital, 252 Wuxing Street, Taipei 110, Taiwan.
authors.forename: Chun-Chieh
authors.initials: CC
authors.lastname: Yeh
authors.forename: Ta-Liang
authors.initials: TL
authors.lastname: Chen
authors.forename: Chaur-Jong
authors.initials: CJ
authors.lastname: Hu
authors.forename: Wen-Ta
authors.initials: WT
authors.lastname: Chiu
authors.forename: Chien-Chang
authors.initials: CC
authors.lastname: Liao
mesh_terms: D000367:Age Factors; D001930:Brain Injuries / Q000150:complications* / Q000453:epidemiology*; D015331:Cohort Studies; D004827:Epilepsy / Q000453:epidemiology* / Q000209:etiology*; D007182:Income; D007345:Insurance Claim Review; D038801:International Classification of Diseases; D011153:Population; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012306:Risk; D012737:Sex Factors; D012887:Skull Fractures / Q000150:complications / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology; D014505:Urban Population