Abstract Details

Title Post Traumatic Seizures (PTS) in Geriatric Traumatic Brain Injury (TBI): A Retrospective Analysis of Incidence, Risk Factors, and Outcomes

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) Neurocritical Care Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 020

Objective

The primary objective was to determine the risk factors for PTS in a geriatric population with TBI. Secondarily we aimed to determine the impact of PTS on outcome.

Background Geriatric patients who sustain a TBI have an increased risk of poor outcomes and higher mortality compared to younger cohorts. PTS are common to both groups, but can lead to more complications and longer intensive care unit stays in this geriatric population. No study to date, has evaluated the risk factors for PTS in the geriatric population.

Design/Methods This single-center retrospective cohort study of patients 65 years of age or older admitted to the Neuroscience Intensive Care Unit at a tertiary referral center with a TBI. Patient charts were evaluated for medical co-morbidities, type of intracranial injury, Glasgow Coma Scale (GCS) on arrival, PTS, anticoagulant therapy, surgical intervention, antiepileptic therapy (AED) and final disposition.

Results Two hundred eighty-three patients were included in the analysis with an overall PTS incidence of 11.7%. The relative risk of poor outcome from TBI (defined as discharge to long-term care facility, hospice, or death) with post-traumatic seizures was 1.41 (95% CI 0.92 - 2.15). The attributable risk of PTS to poor outcomes was 29.09%. Preliminary analysis shows that choice of AED agent, loading dose and time to initiation of therapy do not significantly affect outcome in PTS patients.

Conclusions There is a high attributable risk of PTS to poor outcomes in elderly TBI patients. Further subgroup multivariate analysis is underway to determine if PTS, along with other factors, play a significant role in poor outcomes and what treatment modalities if any, medical or surgical, can alter the outcomes.

Authors/Disclosures
Kunal P. Kanakia, MBBS PRESENTER	Dr. Kanakia has nothing to disclose.
Missak Z. Tchoulhakian, DO	Dr. Tchoulhakian has nothing to disclose.
	No disclosure on file
	No disclosure on file
Christian Kaculini	Christian Kaculini has nothing to disclose.
Shaheryar Hafeez, MD (University of Pittsburgh Medical Center)	Dr. Hafeez has nothing to disclose.
	No disclosure on file

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