PMID- 32221978
OWN - NLM
STAT- MEDLINE
DCOM- 20201016
LR  - 20201016
IS  - 1528-1167 (Electronic)
IS  - 0013-9580 (Linking)
VI  - 61
IP  - 4
DP  - 2020 Apr
TI  - Posttraumatic epilepsy in intensive care unit-treated pediatric traumatic brain 
      injury patients.
PG  - 693-701
LID - 10.1111/epi.16483 [doi]
AB  - OBJECTIVE: Posttraumatic epilepsy (PTE) is a well-described complication of 
      traumatic brain injury (TBI). The majority of the available data regarding PTE 
      stem from the adult population. Our aim was to identify the clinical and 
      radiological risk factors associated with PTE in a pediatric TBI population 
      treated in an intensive care unit (ICU). METHODS: We used the Finnish Intensive 
      Care Consortium database to identify pediatric (<18 years) TBI patients treated 
      in four academic university hospital ICUs in Finland between 2003 and 2013. Our 
      primary outcome was the development of PTE, defined as the need for oral 
      antiepileptic medication in patients alive at 6 months. We assessed the risk 
      factors associated with PTE using multivariable logistic regression modeling. 
      RESULTS: Of the 290 patients included in the study, 59 (20%) developed PTE. 
      Median age was 15 years (interquartile range [IQR] 13-17), and 80% had an 
      admission Glasgow Coma Scale (GCS) score </=12. Major risk factors for developing 
      PTE were age (adjusted odds ratio [OR] 1.08, 95% confidence interval [CI] 
      1.00-1.16), obliterated suprasellar cisterns (OR 6.53, 95% CI 1.95-21.81), and an 
      admission GCS score of 9-12 in comparison to a GCS score of 13-15 (OR 2.88, 95% 
      CI 1.24-6.69). SIGNIFICANCE: We showed that PTE is a common long-term 
      complication after ICU-treated pediatric TBI. Higher age, moderate injury 
      severity, obliterated suprasellar cisterns, seizures during ICU stay, and 
      surgical treatment are associated with an increased risk of PTE. Further studies 
      are needed to identify strategies to decrease the risk of PTE.
CI  - (c) 2020 The Authors. Epilepsia published by Wiley Periodicals, Inc. on behalf of 
      International League Against Epilepsy.
FAU - Mikkonen, Era D
AU  - Mikkonen ED
AUID- ORCID: 0000-0003-1379-0235
AD  - Department of Anesthesiology, Intensive Care and Pain Medicine, Helsinki 
      University Hospital & University of Helsinki, Helsinki, Finland.
AD  - Department of Emergency Care and Services, Helsinki University Hospital & 
      University of Helsinki, Helsinki, Finland.
FAU - Skrifvars, Markus B
AU  - Skrifvars MB
AD  - Department of Emergency Care and Services, Helsinki University Hospital & 
      University of Helsinki, Helsinki, Finland.
FAU - Reinikainen, Matti
AU  - Reinikainen M
AD  - Department of Anaesthesiology and Intensive Care, Kuopio University Hospital and 
      University of Eastern Finland, Kuopio, Finland.
FAU - Bendel, Stepani
AU  - Bendel S
AD  - Department of Anaesthesiology and Intensive Care, Kuopio University Hospital and 
      University of Eastern Finland, Kuopio, Finland.
FAU - Laitio, Ruut
AU  - Laitio R
AD  - Department of Intensive Care, Turku University Hospital and University of Turku, 
      Turku, Finland.
FAU - Hoppu, Sanna
AU  - Hoppu S
AD  - Emergency Medical Services, Department of Intensive Care, Tampere University 
      Hospital & Tampere University, Tampere, Finland.
FAU - Ala-Kokko, Tero
AU  - Ala-Kokko T
AD  - Division of Intensive Care, Medical Research Center Oulu MRC, Oulu University 
      Hospital, Research Group of Anesthesiology, Surgery and Intensive Care Medicine, 
      University of Oulu, Oulu, Finland.
FAU - Karppinen, Atte
AU  - Karppinen A
AD  - Department of Neurosurgery, Helsinki University Hospital and University of 
      Helsinki, Helsinki, Finland.
FAU - Raj, Rahul
AU  - Raj R
AUID- ORCID: 0000-0003-4243-9591
AD  - Department of Neurosurgery, Helsinki University Hospital and University of 
      Helsinki, Helsinki, Finland.
LA  - eng
GR  - Medicinska Understodsforeningen Liv och Halsa/International
GR  - Finska Lakaresallskapet/International
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200328
PL  - United States
TA  - Epilepsia
JT  - Epilepsia
JID - 2983306R
SB  - IM
MH  - Adolescent
MH  - Brain Injuries, Traumatic/*complications
MH  - Child
MH  - Child, Preschool
MH  - Epilepsy, Post-Traumatic/*epidemiology/*etiology
MH  - Female
MH  - Finland/epidemiology
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Intensive Care Units
MH  - Male
MH  - Risk Factors
OTO - NOTNLM
OT  - epilepsy
OT  - intensive care unit
OT  - pediatric
OT  - traumatic brain injury
EDAT- 2020/03/30 06:00
MHDA- 2020/10/21 06:00
CRDT- 2020/03/30 06:00
PHST- 2019/12/19 00:00 [received]
PHST- 2020/03/02 00:00 [revised]
PHST- 2020/03/02 00:00 [accepted]
PHST- 2020/03/30 06:00 [pubmed]
PHST- 2020/10/21 06:00 [medline]
PHST- 2020/03/30 06:00 [entrez]
AID - 10.1111/epi.16483 [doi]
PST - ppublish
SO  - Epilepsia. 2020 Apr;61(4):693-701. doi: 10.1111/epi.16483. Epub 2020 Mar 28.