Acute seizure risk in patients with encephalitis: development and validation of clinical prediction models from two independent prospective multicentre cohorts

• Published in: BMJ neurology open 2022-09, Vol.4 (2), p.e000323
• Main Authors: Wood, Greta K, Babar, Roshan, Ellul, Mark A, Thomas, Rhys Huw, Van Den Tooren, Harriet, Easton, Ava, Tharmaratnam, Kukatharmini, Burnside, Girvan, Alam, Ali M, Castell, Hannah, Boardman, Sarah, Collie, Ceryce, Facer, Bethany, Dunai, Cordelia, Defres, Sylviane, Granerod, Julia, Brown, David W G, Vincent, Angela, Marson, Anthony Guy, Irani, Sarosh R, Solomon, Tom, Michael, Benedict D
• Format: Article
• Language: English
• Subjects: Age; AUTOIMMUNE ENCEPHALITIS; Clinical medicine; CLINICAL NEUROLOGY; Clinical trials; Convulsions & seizures; Disease prevention; Electroencephalography; Encephalitis; Ethnicity; Etiology; Glasgow Coma Scale; INFECTIOUS DISEASES; Original Research; Variables
• ISSN: 2632-6140; 2632-6140
• DOI: 10.1136/bmjno-2022-000323

ObjectiveIn patients with encephalitis, the development of acute symptomatic seizures is highly variable, but when present is associated with a worse outcome. We aimed to determine the factors associated with seizures in encephalitis and develop a clinical prediction model.MethodsWe analysed 203 patients from 24 English hospitals (2005–2008) (Cohort 1). Outcome measures were seizures prior to and during admission, inpatient seizures and status epilepticus. A binary logistic regression risk model was converted to a clinical score and independently validated on an additional 233 patients from 31 UK hospitals (2013–2016) (Cohort 2).ResultsIn Cohort 1, 121 (60%) patients had a seizure including 103 (51%) with inpatient seizures. Admission Glasgow Coma Scale (GCS) ≤8/15 was predictive of subsequent inpatient seizures (OR (95% CI) 5.55 (2.10 to 14.64), p