Abstract WMP87: Incidence and Clinical Predictors of Late Seizures in Survivors of Ischemic Stroke Using a Linking Stroke Registry With Administrative Claims Data

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Purpose: To describe the epidemiology and clinical predictors of late (>7 days) seizures in survivors of acute ischemic stroke (AIS) using the linkage between a national stroke registry and administrative claims databases. Methods: We performed a retrospective cohort study using a big linking database of the Health Insurance Review and Assessment Service (HIRA) claim database during 2007-2017 matched for ischemic stroke patients registered in the Clinical Research Center for Stroke (CRCS) registry from July 2007 to December 2014. Outcome was late seizures occurring after 7-day of the index AIS onset. Post stroke seizures were defined as any inpatient or outpatient treated antiepileptic drug medication with a diagnosis code for epilepsy or seizure after the index stroke based on linking database. We included patients who had 1) AIS within 7 days after symptom onset, 2) no history of previous stroke, 3) no history of seizures and prestroke antiepileptic drug use, 4) no history of potentially epileptogenic comorbidities. Kaplan-Meier methods and Cox Models were used to assess incidence and predictors of late seizures in survivors of AIS. Results: Of 35,106 patients included in this study, 5,279 (15%) patients had late seizures. The cumulative incidence of late seizures after AIS was 7.5% after 1 year, 11.4 % after 3 years, 13.7% after 5 years, 15.8% after 7 years, and 18.3% after 10 years. The crude incidence rate of late seizures after AIS was 26.6 cases per 1,000 person-years in our linking database. Late seizure occurrence tended to be more prevalent in patients having severe stroke (the National Institute of Health Stroke Scale score ≥ 4) and early seizures (≤ 7 days). Small vessel occlusion was less associated with a subsequent late seizure after AIS compared with other etiologies. Conclusions: We found that almost 15 % of patients with AIS developed late seizures within a decade. Severe stroke, early seizure, and ischemic stroke etiology seem to confer the predictors of developing late seizures.