Prophylactic Anticonvulsants in Intracerebral Hemorrhage

Background and Purpose Prophylactic anticonvulsants are routinely prescribed in the acute setting for intracerebral hemorrhage (ICH) patients, but some studies have reported an association with worse outcomes. We sought to characterize the prevalence and predictors of prophylactic anticonvulsant adm...

Full description

Saved in:
Bibliographic Details
Published in:Neurocritical care 2017-10, Vol.27 (2), p.220-228
Main Authors: Mackey, Jason, Blatsioris, Ashley D., Moser, Elizabeth A. S., Carter, Ravan J. L., Saha, Chandan, Stevenson, Alec, Hulin, Abigail L., O’Neill, Darren P., Cohen-Gadol, Aaron A., Leipzig, Thomas J., Williams, Linda S.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Anticonvulsants
Anticonvulsants - adverse effects
Anticonvulsants - therapeutic use
Blood pressure
Cerebral Hemorrhage - complications
Cerebral Hemorrhage - therapy
Critical Care Medicine
Drug Prescriptions - statistics & numerical data
Female
Guideline Adherence - statistics & numerical data
Hemorrhage
Humans
Intensive
Internal Medicine
Ischemia
Levetiracetam
Male
Medical records
Medicine
Medicine & Public Health
Middle Aged
Neurology
Original Article
Outcome Assessment (Health Care) - statistics & numerical data
Patients
Piracetam - adverse effects
Piracetam - analogs & derivatives
Piracetam - therapeutic use
Prevalence
Regression analysis
Retrospective Studies
Seizures - etiology
Seizures - prevention & control
Stroke
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background and Purpose Prophylactic anticonvulsants are routinely prescribed in the acute setting for intracerebral hemorrhage (ICH) patients, but some studies have reported an association with worse outcomes. We sought to characterize the prevalence and predictors of prophylactic anticonvulsant administration after ICH as well as guideline adherence. We also sought to determine whether prophylactic anticonvulsants were independently associated with poor outcome. Methods We performed a retrospective study of primary ICH in our two academic centers. We used a propensity matching approach to make treated and non-treated groups comparable. We conducted multiple logistic regression analysis to identify independent predictors of prophylactic anticonvulsant initiation and its association with poor outcome as measured by modified Rankin score. Results We identified 610 patients with primary ICH, of whom 98 were started on prophylactic anticonvulsants. Levetiracetam (97%) was most commonly prescribed. Age (OR 0.97, 95% CI 0.95–0.99, p  
ISSN:1541-6933
1556-0961
DOI:10.1007/s12028-017-0385-8