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Screening of Risk Factors for Poor Prognosis in Patients with Refractory Epilepsy Secondary to Encephalomalacia

OBJECTIVE: The study was aimed at screening the independent prognostic risk factors for refractory epilepsy associated with encephalomalacia (REAE). METHODS: Patients with REAE treated in the First People's Hospital of Linping District from January 2018 to December 2019 were selected. The progn...

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Autor principal: Zhong, Yinjun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9273423/
https://www.ncbi.nlm.nih.gov/pubmed/35832138
http://dx.doi.org/10.1155/2022/5720102
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author Zhong, Yinjun
author_facet Zhong, Yinjun
author_sort Zhong, Yinjun
collection PubMed
description OBJECTIVE: The study was aimed at screening the independent prognostic risk factors for refractory epilepsy associated with encephalomalacia (REAE). METHODS: Patients with REAE treated in the First People's Hospital of Linping District from January 2018 to December 2019 were selected. The prognosis was represented by Engel grading. Clinical data of the patients were collected, including age, sex, BMI, lesion sites, number of lesion sites, lesion size, seizure frequency, epilepsy type, and treatment methods. Independent risk factors for poor prognosis were screened by logistic regression analysis. The receiver operating characteristic curve (ROC) was used to evaluate the prognostic efficacy of independent risk factors. RESULTS: A total of 48 patients were included in this study, including 31 patients (64.58%) in the good prognosis group and 17 patients (35.42%) in the poor prognosis group. The mean age of the poor prognosis group was higher than that of the good prognosis group (P = 0.002). The proportion of patients with multisite lesions in the poor prognosis group was higher than that in the good prognosis group (P = 0.016). The proportion of patients with cerebral malacia lesion diameter ≥ 3 cm in the poor prognosis group was higher than that in the good prognosis group (P = 0.002). The proportion of patients with attack frequency ≥ 2 times/month in the poor prognosis group was higher than in the good prognosis group (P = 0.002). The proportion of patients receiving surgical treatment in the poor prognosis group was lower than that in the good prognosis group (P < 0.001). Age, number of lesion sites, size of encephalomalacia, and seizure frequency were independent risk factors for the prognosis of patients with REAE (OR > 1, P < 0.05). Surgical treatment was an independent protective factor associated with the prognosis of patients with REAE (OR < 1, P < 0.05). The area under the ROC curve of surgical treatment was 0.83 (P = 0.004). The area under the ROC curve of the size of encephalomalacia was 0.72 (P = 0.008). There was a positive correlation between age and size of encephalomalacia and Engel grade (r > 0, P < 0.05). Surgical treatment was negatively correlated with Engel grade (r < 0, P < 0.05). The number of lesion sites and seizure frequency had no significant correlation with Engel (P > 0.05). The proportion of Engel I patients treated with surgery was higher than that treated with drugs (P = 0.001). The ratio of Engel III and IV patients treated with surgery was lower than that treated with medications (P < 0.05). CONCLUSION: Age, number of lesion sites, size of encephalomalacia, and seizure frequency are independent risk factors for the prognosis of patients with REAE. Surgical treatment is an independent prognostic factor for patients with REAE. Surgical treatment can significantly improve patient outcomes.
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spelling pubmed-92734232022-07-12 Screening of Risk Factors for Poor Prognosis in Patients with Refractory Epilepsy Secondary to Encephalomalacia Zhong, Yinjun Comput Math Methods Med Research Article OBJECTIVE: The study was aimed at screening the independent prognostic risk factors for refractory epilepsy associated with encephalomalacia (REAE). METHODS: Patients with REAE treated in the First People's Hospital of Linping District from January 2018 to December 2019 were selected. The prognosis was represented by Engel grading. Clinical data of the patients were collected, including age, sex, BMI, lesion sites, number of lesion sites, lesion size, seizure frequency, epilepsy type, and treatment methods. Independent risk factors for poor prognosis were screened by logistic regression analysis. The receiver operating characteristic curve (ROC) was used to evaluate the prognostic efficacy of independent risk factors. RESULTS: A total of 48 patients were included in this study, including 31 patients (64.58%) in the good prognosis group and 17 patients (35.42%) in the poor prognosis group. The mean age of the poor prognosis group was higher than that of the good prognosis group (P = 0.002). The proportion of patients with multisite lesions in the poor prognosis group was higher than that in the good prognosis group (P = 0.016). The proportion of patients with cerebral malacia lesion diameter ≥ 3 cm in the poor prognosis group was higher than that in the good prognosis group (P = 0.002). The proportion of patients with attack frequency ≥ 2 times/month in the poor prognosis group was higher than in the good prognosis group (P = 0.002). The proportion of patients receiving surgical treatment in the poor prognosis group was lower than that in the good prognosis group (P < 0.001). Age, number of lesion sites, size of encephalomalacia, and seizure frequency were independent risk factors for the prognosis of patients with REAE (OR > 1, P < 0.05). Surgical treatment was an independent protective factor associated with the prognosis of patients with REAE (OR < 1, P < 0.05). The area under the ROC curve of surgical treatment was 0.83 (P = 0.004). The area under the ROC curve of the size of encephalomalacia was 0.72 (P = 0.008). There was a positive correlation between age and size of encephalomalacia and Engel grade (r > 0, P < 0.05). Surgical treatment was negatively correlated with Engel grade (r < 0, P < 0.05). The number of lesion sites and seizure frequency had no significant correlation with Engel (P > 0.05). The proportion of Engel I patients treated with surgery was higher than that treated with drugs (P = 0.001). The ratio of Engel III and IV patients treated with surgery was lower than that treated with medications (P < 0.05). CONCLUSION: Age, number of lesion sites, size of encephalomalacia, and seizure frequency are independent risk factors for the prognosis of patients with REAE. Surgical treatment is an independent prognostic factor for patients with REAE. Surgical treatment can significantly improve patient outcomes. Hindawi 2022-07-04 /pmc/articles/PMC9273423/ /pubmed/35832138 http://dx.doi.org/10.1155/2022/5720102 Text en Copyright © 2022 Yinjun Zhong. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Zhong, Yinjun
Screening of Risk Factors for Poor Prognosis in Patients with Refractory Epilepsy Secondary to Encephalomalacia
title Screening of Risk Factors for Poor Prognosis in Patients with Refractory Epilepsy Secondary to Encephalomalacia
title_full Screening of Risk Factors for Poor Prognosis in Patients with Refractory Epilepsy Secondary to Encephalomalacia
title_fullStr Screening of Risk Factors for Poor Prognosis in Patients with Refractory Epilepsy Secondary to Encephalomalacia
title_full_unstemmed Screening of Risk Factors for Poor Prognosis in Patients with Refractory Epilepsy Secondary to Encephalomalacia
title_short Screening of Risk Factors for Poor Prognosis in Patients with Refractory Epilepsy Secondary to Encephalomalacia
title_sort screening of risk factors for poor prognosis in patients with refractory epilepsy secondary to encephalomalacia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9273423/
https://www.ncbi.nlm.nih.gov/pubmed/35832138
http://dx.doi.org/10.1155/2022/5720102
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