The rate of spontaneous Intracerebral Hemorrhage (sICH) is rising among young Americans. Trends in acute seizure (AS) incidence in this age group is largely unknown. Further, the association of AS with mortality has not been reported in this age group. The aim of this study is to determine trends in AS among young individuals with sICH. The Merative MarketScan® Commercial Claims and Encounters database, for the years 2005 through 2015, served as the data source for this retrospective in-hospital population study. This period was chosen as spontaneous ICH incidence increased among young individuals between 2005 and 2015. Our study population included patients aged 18–64 years with ICH identified using the International Classification of Diseases, Ninth and Tenth Revision (ICD-9/10) codes 430, 431, 432.0, 432.1, 432.9, I61, I61.0, I61.1, I61.2, I61.3, I61.4, I61.5, I61.6, I61.8, and I61.9, excluding those with a prior diagnosis of seizures (ICD-9/10 codes 345.x,780.3x, G40, G41, and R56.8). We computed yearly AS incidence, mortality (in patients with and without seizures), and analyzed trends. We applied a logistic regression model to determine the independent association of AS with mortality accounting for demographic and clinical variables. AS incidence increased linearly between 2005 (incidence rate: 8.1 %) and 2015 (incidence rate: 11.0 %), which represents a 26 % relative increase (P for trends <0.0001). In-hospital mortality rate was 14.3 % among those who developed AS and 11.5 % among those who did not have AS. Overall, between 2005 and 2015, in-hospital mortality decreased from 13.0 % to 9.7 % among patients without AS but remained unchanged among those with AS. Patients who developed AS were 10 % more likely to die than those who did not (OR: 1.10, 95 % confidence interval: 1.02–1.18). Between 2005 and 2015, the incidence of AS increased by nearly 26 % among young Americans with sICH. In-patient mortality remained unchanged among those who developed seizures but declined among those who did not. The occurrence of AS was independently associated with a 10 % higher risk of in-hospital death.

中文翻译：

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年轻人自发性脑出血后的急性癫痫发作：11 年趋势及其与死亡率的关系


美国年轻人自发性脑出血（sICH）的发生率正在上升。该年龄组急性癫痫发作 (AS) 发病率的趋势很大程度上未知。此外，该年龄组中尚未有 AS 与死亡率关联的报道。本研究的目的是确定患有 sICH 的年轻人中 AS 的趋势。 2005 年至 2015 年的 Merative MarketScan® 商业索赔和遭遇数据库作为这项回顾性住院人群研究的数据源。选择这一时期是因为 2005 年至 2015 年间，年轻人中自发性 ICH 发病率有所增加。我们的研究人群包括年龄为 18-64 岁、患有 ICH 的患者，这些患者使用国际疾病分类第九和第十修订版 (ICD-9/10) 代码 430 进行了识别、431、432.0、432.1、432.9、I61、I61.0、I61.1、I61.2、I61.3、I61.4、I61.5、I61.6、I61.8 和 I61.9，不包括这些既往诊断为癫痫发作（ICD-9/10 代码 345.x、780.3x、G40、G41 和 R56.8）。我们计算了每年的 AS 发病率、死亡率（有或没有癫痫发作的患者），并分析了趋势。我们应用逻辑回归模型来确定 AS 与死亡率的独立关联（考虑人口和临床变量）。 AS 发病率在 2005 年（发病率：8.1%）和 2015 年（发病率：11.0%）之间线性增加，相对增加了 26%（趋势 P <0.0001）。患有 AS 的院内死亡率为 14.3%，未患有 AS 的院内死亡率为 11.5%。总体而言，2005 年至 2015 年间，无 AS 患者的院内死亡率从 13.0% 下降至 9.7%，但 AS 患者的院内死亡率保持不变。患 AS 的患者比未患 AS 的患者死亡可能性高 10%（OR：1.10，95% 置信区间：1.02–1.18）。 2005 年至 2015 年间，患有 sICH 的美国年轻人的 AS 发病率增加了近 26%。发生癫痫发作的患者的住院死亡率保持不变，但未发生癫痫发作的患者的住院死亡率有所下降。 AS 的发生与院内死亡风险增加 10% 独立相关。