Abstract WP152: Trends In Stroke Patients With Associated Seizures: A 20-year Analysis Of The National Inpatient Sample From 2000-2019

Background: Seizure is a known complication following acute ischemic stroke (AIS) that can lead to severe morbidity. We sought to better characterize the risk factors for stroke following AIS and evaluate in-hospital outcomes in these patients. Methods: A query of the 2000-2019 National Inpatient Sample was performed for patients admitted with AIS (ICD9 433, 43401, 43411, 43491, ICD-10 I63). Demographics, comorbidities, and outcomes were identified. Univariate analysis with t-tests or chi-square performed as appropriate. A 1:1 nearest neighbor propensity score matched cohort was generated. Variables with standardized mean differences >0.1 used in multivariate regression to generate adjusted odds ratios (AOR)/β-coefficients for dysphagia on outcomes. Significance set at an alpha level of <0.001. All analysis performed in R version 4.1.3. Results: A total of 10,415,286 patients with AIS were identified; 694,495 (6.6%) had seizures. Patients with seizures had higher Elixhauser Comorbidity Score (14.81 ± 8.13 vs. 9.40 ± 8.76; p<0.001) and NIH Stroke Scale (NIHSS) Score (9.46 ± 8.68 vs. 6.50 ± 7.18; p<0.001). Patients with seizures were more likely to be female, younger, African American race, smokers, covered on Medicaid, be in the 0-25% percentile median income bracket, and be placed on a ventilator (all p<0.001). After propensity matching, seizure patients were slightly less likely to experience in-hospital mortality (AOR 0.94; 95%CI: 0.92-0.97), less likely to be discharged home (AOR 0.92, 95%CI:0.9-0.93), and had increased hospital charges ($6696.08; 95%CI: $5728.65-7663.51)(all p<0.001). Conclusions: Approximately 7% of patients with AIS experience seizure while hospitalized, with an overall stable incidence over 20 years. Seizure is more likely to occur in women and younger patients and is associated with worse functional outcomes. The percentage of patients with seizures in AIS remained similar per year despite an increase in the absolute numbers.