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Meta-Analysis
. 2016 Jul;95(27):e4117.
doi: 10.1097/MD.0000000000004117.

Association between seizures after ischemic stroke and stroke outcome: A systematic review and meta-analysis

Tao Xu  1 , Shu Ou, Xi Liu, Xinyuan Yu, Jinxian Yuan, Hao Huang, Yangmei Chen
Affiliations
Meta-Analysis

Association between seizures after ischemic stroke and stroke outcome: A systematic review and meta-analysis

Tao Xu et al. Medicine (Baltimore). 2016 Jul.

Abstract

A systematic review and meta-analysis were performed to investigate a potential association between post-ischemic stroke seizures (PISS) and subsequent ischemic stroke (IS) outcome.A systematic search of two electronic databases (Medline and Embase) was conducted to identify studies that explored an association between PISS and IS outcome. The primary and secondary IS outcomes of interest were mortality and disability, respectively, with the latter defined as a score of 3 to 5 on the modified Rankin Scale.A total of 15 studies that were published between 1998 and 2015 with 926,492 participants were examined. The overall mortality rates for the patients with and without PISS were 34% (95% confidence interval [CI], 27-42%) and 18% (95% CI, 12-23%), respectively. The pooled relative ratio (RR) of mortality for the patients with PISS was 1.97 (95% CI, 1.48-2.61; I = 88.6%). The overall prevalence rates of disability in the patients with and without PISS were 60% (95% CI, 32-87%) and 41% (95% CI, 25-57%), respectively. Finally, the pooled RR of disability for the patients with PISS was 1.64 (95% CI, 1.32-2.02; I = 66.1%).PISS are significantly associated with higher risks of both mortality and disability. PISS indicate poorer prognoses in patients experiencing IS.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flowchart of the literature search performed.
Figure 2
Figure 2
Forest plots of the overall mortality in patients with (A) and without (B) PISS. PISS = post-ischemic stroke seizures.
Figure 3
Figure 3
Forest plots of the association between PISS and risk of mortality (A) and the subgroup analyses that were performed to investigate the association between PISS and risk of mortality (B). PISS = post-ischemic stroke seizures.
Figure 4
Figure 4
Forest plots of the overall prevalence of disability in patients with (A) and without (B) PISS. PISS = post-ischemic stroke seizures.
Figure 5
Figure 5
Forest plots of the association between PISS and risk of disability (A) and the subgroup analyses that were performed to investigate the association between PISS and risk of disability (B). PISS = post-ischemic stroke seizures.
See this image and copyright information in PMC

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