Abstract W MP92: The CAVE Score for Predicting Late Seizures after Intracerebral Hemorrhage
Background and Purpose: Intracerebral hemorrhage (ICH) related seizures have not been thoroughly investigated. We evaluated their frequency, predictors, and influence on patient outcome. We then created and validated a simple score to estimate the risk of developing late seizures (LS).
Methods: Consecutive ICH patients’ (n=993) province-wide electronic patient records were retrospectively evaluated for onset seizures (OS), acute seizures (AS, occurring within 7 days from stroke), and among 7-day survivors (n=764), also LS occurring >7 days from stroke. A Cox regression model estimating variables associated with risk of LS was used to derive a simple integer-based prognostic score. The score was validated externally in a prospective cohort of ICH patients from Lille, France (n=325).
Results: Of the total cohort, 64 (6.5%) had OS and 61 (6.1%) AS. Among the 7-day survivors, during a median follow-up of 2.7 years, 70 (9.2%) patients developed LS. The cumulative risk of LS among survivors was 7.1% at 1 year after ICH, 10.0% at 2 years, 10.2% at 3 years, 11.0% at 4 years, and 11.8% at 5 years. Seizures at any time point were not associated with increased mortality. We created the CAVE score (0 to 4 points) to predict risk of LS, with one point for each of: Cortical involvement, Age<65 years, Volume >10 mL, and Early seizures at onset or within 7 days of ICH. The corresponding risk of LS was 0.6%, 3.6%, 9.8%, 34.8%, and 46.2%, for CAVE scores 0-4, respectively, with AUC-ROC of 0.81 (0.76-0.86). The score stratified risk of LS also in the validation cohort, being 3.1%, 5.0%, 15.8%, 13.5%, and 37.5% respectively, with AUC-ROC of 0.69 (0.59-0.78).
Conclusion: One in ten patients will develop seizures after ICH. This adverse outcome can be predicted by a simple score based on baseline variables.
Author Disclosures: E. Haapaniemi: None. D. Strbian: None. C. Rossi: None. J. Putaala: None. T. Sipi: None. S. Mustanoja: None. T. Sairanen: None. S. Curtze: None. J. Satopää: None. R. Roivainen: None. M. Kaste: None. C. Cordonnier: None. T. Tatlisumak: None. A. Meretoja: Employment; Significant; University of Melbourne.
- © 2014 by American Heart Association, Inc.