Association of Prevalent Stroke with Hospitalization for Seizure: Patterns and Prognoses

Introduction: Despite the close relationship between stroke and seizures, little is known about stroke trends and inpatient mortality among patients with seizures. Materials and Methods: The National Inpatient Sample was used to analyze the prevalence and trends of stroke among patients discharged with a primary diagnosis of seizures between 2006 and 2014. International Classification of Diseases, Ninth Revision, Clinical Modification was used to identify patients discharged with a primary diagnosis of seizures and those with a secondary diagnosis of stroke. Multivariable logistic regression was used to examine the association between inpatient hospital mortality and stroke. Adjusted prediction of mortality post estimates of logistic regression was used to analyze mortality by stroke status overtime. Findings: A total of 400,391 (weighted 1,980,707) patients with seizures were identified between 2006 and 2014, including 61,039 weighted (3%) with a secondary diagnosis of stroke patients. Among patients with a primary diagnosis of seizures, having a secondary diagnosis of stroke doubled the odds of in-hospital death (odds ratio = 2.02; 95% confidence interval: 1.74-2.34; P < .001). Overall, between 2006 and 2014, the prevalence of stroke among patients discharged with a primary diagnosis of seizures remained stable at 3% amid fluctuations across years. Among patients with a primary discharge diagnosis of seizures who had stroke, in-hospital mortality increased from 2.3% in 2006 to 3.6% in 2014 but decreased from .8% in 2006 to .7% in 2014 in those without stroke. Conclusions: Stroke is prevalent and is associated with increased mortality among patients who are discharged with a primary diagnosis of seizure, with a stable prevalence but suggested increased mortality across time.