Options
Long-term Incidence and Risk Factors for Postischemic Stroke Epilepsy in Young Adults and Mesenchymal Stem Cell Overexpressing Fibroblast Grow Factor 21 Transplantation Improves Neurological Outcomes After Ischemic Stroke
Other Title
Long-term Incidence and Risk Factors for Postischemic Stroke Epilepsy in Young Adults and Mesenchymal Stem Cell Overexpressing Fibroblast Grow Factor 21 Transplantation Improves Neurological Outcomes After Ischemic Stroke
Type
thesis
Date Issued
2022-06-28
Author(s)
DO PHUONG THAO
Advisor
胡朝榮
Subjects
系所名稱：細胞治療與再生醫學國際博士學位學程
Publisher
細胞治療與再生醫學國際博士學位學程
Description
口試委員：王家儀 Jia-Yi Wang ;陳凱筠 Kai-Yun Chen;蔡力凱 Li-Kai Tsai;周中興 Chung-Hsing Chou;胡朝榮 Chaur-Jong Hu
網際網路,開放日期為2026-12-31
網際網路,開放日期為2026-12-31
Abstract
Background: The trend towards higher ischemic stroke prevalence is emerging in younger population in the past 20 years. However, few population-based studies with long-term follow-up have investigated on predictive factors of post stroke epilepsy (PSE), especially factors related to comorbidities and unhealthy behaviors in the young people in modern life. Accordingly, the present study aimed to identify the long-term incidence and the risk factors for PSE development in stroke patients aged 19-44.
Methods: This retrospective cohort study used Taiwan National Health Insurance Research Database (NHIRD) from the years 2002 to 2018. We collected all ischemic stroke patients aged 19–44 from 2002 to 2015 with follow-up of at least three years. Multivariable Cox regression analysis were performed to evaluate the association between PSE occurrence and the potential risk factors, including patient demographics, stroke recurrence, stroke severity, etiologies, underlying conditions, and unhealthy lifestyles.
Results: Among 6,512 patients, 402 cases (6.2%) developed epilepsy throughout a mean 8.3-year follow-up period. During the overall follow-up, stroke severity and manifestations were associated with PSE, including seizure at first stroke admission [adjusted hazard ratio (aHR), 57.39; 95% confidence interval (CI), 43.02–76.55], National Institutes of Health Stroke Scale (NIHSS) score ≥10 (aHR, 1.98; 95% CI, 1.50–2.61), length of hospitalization ≥14 days (aHR, 1.60; 95% CI, 1.26–2.02), stroke recurrence (aHR, 2.32; 95% CI, 1.85–2.90), language disorders (aHR, 1.77; 95%CI, 1.20–2.60), and malignancy (aHR, 2.05; 95%CI, 1.30–3.24). Moreover, illicit and recreational drug use was 2.90 times more present in the PSE group than those without (aHR, 2.90; 95% CI, 1.53–5.50). By contrast, statin use was associated with a decreased incidence of PSE (aHR, 0.62; 95% CI, 0.48-0.80).
Conclusions: The severity of stroke, seizure, aphasia, malignancy, and drug abuse were all linked to an elevated risk for occurrence of PSE and statin use may protect against PSE in young patients. Diminishing stroke severity, using statin, and eliminating unhealthy lifestyles might be able to reduce future PSE development. Understanding risk factors for developing PSE in young patients might aid in determining the targeted population who may benefit from interventions to alleviate epileptogenesis.
Methods: This retrospective cohort study used Taiwan National Health Insurance Research Database (NHIRD) from the years 2002 to 2018. We collected all ischemic stroke patients aged 19–44 from 2002 to 2015 with follow-up of at least three years. Multivariable Cox regression analysis were performed to evaluate the association between PSE occurrence and the potential risk factors, including patient demographics, stroke recurrence, stroke severity, etiologies, underlying conditions, and unhealthy lifestyles.
Results: Among 6,512 patients, 402 cases (6.2%) developed epilepsy throughout a mean 8.3-year follow-up period. During the overall follow-up, stroke severity and manifestations were associated with PSE, including seizure at first stroke admission [adjusted hazard ratio (aHR), 57.39; 95% confidence interval (CI), 43.02–76.55], National Institutes of Health Stroke Scale (NIHSS) score ≥10 (aHR, 1.98; 95% CI, 1.50–2.61), length of hospitalization ≥14 days (aHR, 1.60; 95% CI, 1.26–2.02), stroke recurrence (aHR, 2.32; 95% CI, 1.85–2.90), language disorders (aHR, 1.77; 95%CI, 1.20–2.60), and malignancy (aHR, 2.05; 95%CI, 1.30–3.24). Moreover, illicit and recreational drug use was 2.90 times more present in the PSE group than those without (aHR, 2.90; 95% CI, 1.53–5.50). By contrast, statin use was associated with a decreased incidence of PSE (aHR, 0.62; 95% CI, 0.48-0.80).
Conclusions: The severity of stroke, seizure, aphasia, malignancy, and drug abuse were all linked to an elevated risk for occurrence of PSE and statin use may protect against PSE in young patients. Diminishing stroke severity, using statin, and eliminating unhealthy lifestyles might be able to reduce future PSE development. Understanding risk factors for developing PSE in young patients might aid in determining the targeted population who may benefit from interventions to alleviate epileptogenesis.