{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T21:55:46Z","timestamp":1792619746296,"version":"4.5.0"},"reference-count":99,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Neurol"],"published-print":{"date-parts":[[2023,11,1]]},"abstract":"<jats:sec id=\"ab-noi230065-4\"><jats:title>Importance<\/jats:title><jats:p>Published data about the impact of poststroke seizures (PSSs) on the outcomes of patients with stroke are inconsistent and have not been systematically evaluated, to the authors\u2019 knowledge.<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi230065-5\"><jats:title>Objective<\/jats:title><jats:p>To investigate outcomes in people with PSS compared with people without PSS.<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi230065-6\"><jats:title>Data Sources<\/jats:title><jats:p>MEDLINE, Embase, PsycInfo, Cochrane, LILACS, LIPECS, and Web of Science, with years searched from 1951 to January 30, 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi230065-7\"><jats:title>Study Selection<\/jats:title><jats:p>Observational studies that reported PSS outcomes.<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi230065-8\"><jats:title>Data Extraction and Synthesis<\/jats:title><jats:p>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was used for abstracting data, and the Joanna Briggs Institute tool was used for risk-of-bias assessment. Data were reported as odds ratio (OR) and standardized mean difference (SMD) with a 95% CI using a random-effects meta-analysis. Publication bias was assessed using funnel plots and the Egger test. Outlier and meta-regression analyses were performed to explore the source of heterogeneity. Data were analyzed from November 2022 to January 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi230065-9\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Measured outcomes were mortality, poor functional outcome (modified Rankin scale [mRS] score 3-6), disability (mean mRS score), recurrent stroke, and dementia at patient follow-up.<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi230065-10\"><jats:title>Results<\/jats:title><jats:p>The search yielded 71 eligible articles, including\u200920\u202f110 patients with PSS and 1\u202f166\u202f085 patients without PSS. Of the participants with PSS, 1967 (9.8%) had early seizures, and 10\u202f605 (52.7%) had late seizures. The risk of bias was high in 5 studies (7.0%), moderate in 35 (49.3%), and low in 31 (43.7%). PSSs were associated with mortality risk (OR, 2.1; 95% CI, 1.8-2.4), poor functional outcome (OR, 2.2; 95% CI, 1.8-2.8), greater disability (SMD, 0.6; 95% CI, 0.4-0.7), and increased dementia risk (OR, 3.1; 95% CI, 1.3-7.7) compared with patients without PSS. In subgroup analyses, early seizures but not late seizures were associated with mortality (OR, 2.4; 95% CI, 1.9-2.9 vs OR, 1.2; 95% CI, 0.8-2.0) and both ischemic and hemorrhagic stroke subtypes were associated with mortality (OR, 2.2; 95% CI, 1.8-2.7 vs OR, 1.4; 95% CI, 1.0-1.8). In addition, early and late seizures (OR, 2.4; 95% CI, 1.6-3.4 vs OR, 2.7; 95% CI, 1.8-4.1) and stroke subtypes were associated with poor outcomes (OR, 2.6; 95% CI, 1.9-3.7 vs OR, 1.9; 95% CI, 1.0-3.6).<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi230065-11\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>Results of this systematic review and meta-analysis suggest that PSSs were associated with significantly increased mortality and severe disability in patients with history of stroke. Unraveling these associations is a high clinical and research priority. Trials of interventions to prevent seizures may be warranted.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaneurol.2023.3240","type":"journal-article","created":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T15:00:45Z","timestamp":1695049245000},"page":"1155","source":"Crossref","is-referenced-by-count":67,"title":["Outcomes in Patients With Poststroke Seizures"],"prefix":"10.1001","volume":"80","author":[{"given":"Shubham","family":"Misra","sequence":"first","affiliation":[{"name":"Division of Stroke & Vascular Neurology, Department of Neurology, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott E.","family":"Kasner","sequence":"additional","affiliation":[{"name":"The University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse","family":"Dawson","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomotaka","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yize","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitten P.","family":"Zaveri","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ece","family":"Eldem","sequence":"additional","affiliation":[{"name":"Division of Stroke & Vascular Neurology, Department of Neurology, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Vazquez","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Sc\u00e1rdua","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medical Sciences, University of Campinas-UNICAMP, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saba","family":"Mohidat","sequence":"additional","affiliation":[{"name":"The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. 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