The Predictive Risk Factors of Seizures in Stroke Patients Admitted for Rehabilitation at Sirindhorn National Medical Rehabilitation Institute

Abstract

Background: Seizures are common complications in stroke patients, and impact the rehabilitation process and recovery ability. Objective: To identify the predictive risk factors of seizure in stroke patients admitted to Sirindhorn National Medical Rehabilitation Institute. Methods: Retrospective cohort study in 734 stroke patients who were admitted to Sirindhorn National Medical Rehabilitation Institute from October 1, 2020, through September 30, 2024 was performed. We used a logistic regression model to identify the associated risk factor, including clinical symptoms, laboratory before admission and complications during hospitalization. Results: A total of 734 patients were included, with 450 male (61.3%). The average age was 61.5 years (SD = 14.2) The average age at first stroke onset was 60.1 years (SD = 14.2). A total of 421 patients (57.4%) had ischemic stroke. Sixteen patients (2.2%) had seizures during hospitalization. There were four predictive risk factors for seizure. Firstly, cortical lobe signs: aphasia increased the risk by 5.17 times (95%CI: 1.10, 24.27) and neglect increased the risk by 7.20 times (95%CI: 1.06, 48.88). Secondly, history of craniectomy or craniotomy increased the risk by 6.35 times (95%CI: 1.05, 38.32). Thirdly, admitted patients with less than one year since their last seizure had 43.75 times (95%CI: 8.31, 230.23) higher risk than patients who had never been seizure or had seizure longer than one year. Fourthly, the abnormal serum sodium level during admission increased the risk by 11.89 times (95%CI: 1.19, 118.67). Conclusion: There were four predictive risk factors for seizures in stroke patients who admitted for rehabilitation. 1) cortical lobe signs presented, 2) History of craniectomy/craniotomy, 3) time from last seizure less than one year and 4) The abnormal serum sodium level. Identifying these factors can help medical personnel assess the risk more accurately and plan for preventive and treatment strategies.