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Research paper
Risk of epilepsy after traumatic brain injury: a retrospective population-based cohort study
  1. Chun-Chieh Yeh1,2,
  2. Ta-Liang Chen3–5,
  3. Chaur-Jong Hu6,
  4. Wen-Ta Chiu7,
  5. Chien-Chang Liao3–5
  1. 1Department of Surgery, China Medical University Hospital, Taichung, Taiwan
  2. 2Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
  3. 3Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
  4. 4Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
  5. 5School of Medicine, Taipei Medical University, Taipei, Taiwan
  6. 6Department of Neurology, Taipei Medical University, Taipei, Taiwan
  7. 7Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan
  1. Correspondence to Assistant Professor Chien-Chang Liao, Department of Anesthesiology, Taipei Medical University Hospital, 252 Wuxing Street, Taipei 110, Taiwan; jacky48863027{at}yahoo.com.tw

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.

  • Head Injury
  • Epilepsy
  • Epidemiology

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