title: Association between seizures and outcomes among intracerebral hemorrhage patients: the China National Stroke Registry.
abstract: BACKGROUND
  To determine whether the presence of seizures in patients with spontaneous intracerebral hemorrhage (ICH) was associated with in-hospital complications and measured outcomes.
  
  
  METHODS
  This prospective cohort study from the China National Stroke Registry included consecutive patients with ICH between August 2007 and September 2008. In-hospital complications, functional outcomes, and mortality at 3, 6, and 12 months were compared between patients with seizures and those without seizures occurring at ICH onset and during hospitalization. Poor functional outcome was defined as a modified Rankin Scale score between 3 and 6. Poor functional outcome and mortality were stratified by stroke severity using Glasgow Coma Scale scores on admission.
  
  
  RESULTS
  The study included 3216 patients with ICH and 139 of them (4.3%) experienced seizures. The presence of seizures was associated with high in-hospital complications including atrial fibrillation (P = .004), pneumonia (P = .001), as well as lower rehabilitation assessment rates (P = .033) compared with patients without seizures. ICH patients with seizures had poorer functional outcome at 3-month (P = .012), 6-month (P = .007), and 12-month (P = .001) follow-up. They also had higher mortality at 3 months (P = .045), 6 months (P = .005), and 12 months (P = .002). Patients with mild strokes had poorer functional outcome and higher mortality (P < .005) if seizures occurred.
  
  
  CONCLUSIONS
  The presence of seizures in patients with ICH was associated with high in-hospital complications and indicates poor outcomes at 3-, 6-, and 12-month follow-up. Quality improvement strategies targeting ICH patients with seizures especially mild stroke may help improve prognoses.
authors.affiliation: Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China.
authors.forename: Zixiao
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China.
authors.forename: Xingquan
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China.
authors.forename: Yilong
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.
authors.forename: Chunxue
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.
authors.forename: Liping
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China.
authors.forename: Xiaoqiu
authors.initials: X
authors.lastname: Shao
authors.affiliation: Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
authors.forename: Wenjuan
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.
authors.forename: Yuesong
authors.initials: Y
authors.lastname: Pan
authors.affiliation: Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
authors.forename: Chunjuan
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China.
authors.forename: Ruijun
authors.initials: R
authors.lastname: Ji
authors.affiliation: Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China.
authors.forename: Changqing
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Jing
authors.affiliation: Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China. Electronic address: yongjunwang1962@gmail.com.
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000401:mortality; D002681:China; D015331:Cohort Studies; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020127:Recovery of Function; D012042:Registries; D012307:Risk Factors; D012640:Seizures / Q000453:epidemiology* / Q000401:mortality; D020521:Stroke / Q000453:epidemiology* / Q000401:mortality
keywords: Intracerebral hemorrhage; all epilepsy/seizures; outcome research; risk factors