Sepsis May Increase Risk of Long-Term Seizures

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Sepsis is associated with pathways that lead to permanent neurological sequelae, according to research presented at the 2017 AAN annual meeting.

The risk of long-term seizures is significantly higher in survivors of sepsis compared with the general population, according to research presented at the 2017 annual meeting of the American Academy of Neurology (AAN) in Boston, Massachusetts.

Michael Reznik, MD, from the department of neurology at Columbia University Medical Center and Weill Cornell Medicine in New York, and colleagues conducted a retrospective population-based cohort study at nonfederal acute care hospitals in California, Florida, and New York. In order to examine the association between sepsis and the long-term risk of seizures, Dr Reznik and colleagues reviewed administrative claims data from 2005 to 2013 on all adult patients admitted to the emergency department or hospitalized for seizures. Patients with seizures before or during the index sepsis hospitalization were excluded from the study.

A total of 842,723 patients were identified with sepsis. In patients with sepsis, the annual incidence of seizure was 1.28% (95% CI, 1.27-1.30) vs 0.1589% (95% CI, 0.1585-0.1593) in the general population (incidence rate ratios [IRR] 4.97; 95% CI, 4.92-5.04). In sepsis survivors, the cumulative seizure rate after 8 years was 6.67% (95% CI 6.57-6.78) vs 1.27% (95% CI 1.27-1.28) in the general population.

In order to confirm their findings, Dr Reznik and colleagues evaluated inpatient and outpatient claims data from a nationally representative 5% sample of Medicare beneficiaries. This analysis showed that sepsis hospitalization was less strongly associated with subsequent seizures (IRR 2.72; 95% CI, 2.60-2.83).

In a post-hoc subgroup analysis of the statewide data stratified by age, like the Medicare analysis, sepsis was similarly associated with seizures in patients ≥65 years of age (IRR 2.8; 95% CI 2.8-2.9) and more strongly among those <65 years of age (IRR 10.3; 95% CI, 10.2-10.5).

“We found that survivors of sepsis faced a significantly higher long-term risk of seizures than the general population, suggesting that sepsis is associated with pathways that lead to permanent neurological sequelae,” concluded the researchers.

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Reznik M, Merkler A, Mahta A, Murthy S, Claassen J, Kamel H. Long-term risk of seizures in survivors of sepsis. Presented at: The 69th AAN Annual Meeting. Boston, MA; April 22-28, 2017. Abstract S5.003.