Patients with sepsis have a greater long-term risk for seizures compared with hospitalized patients without sepsis and the general population, according to findings from a retrospective study published in Neurology.
Researchers retrospectively reviewed administrative claims data collected from hospital admissions and visits to the emergency department during 2005 and 2013. The ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) system identified those patients who were hospitalized with a sepsis diagnosis (n=842,735). The primary outcome was comprised of either any visit to the emergency department or hospital admission for seizure incidence.
In all patients with sepsis included in this analysis, the investigators found an annual seizure incidence of 1.29% (95% CI, 1.27%-1.30%) compared with 0.16% (95% CI, 0.16%-0.16%) in the overall population (incidence rate ratio [IRR] 4.98; 95% CI, 4.92-5.04). The researchers matched patients with sepsis with hospitalized patients without a sepsis diagnosis, which validated the initial findings (IRR 4.33; 95% CI, 4.13-4.55). An additional analysis consisting of Medicare beneficiaries demonstrated a similar correlation (IRR 2.72; 95% CI, 2.60-2.83).
The researchers believed that the reliance on ICD-9-CM codes to determine sepsis may have led to “misclassification of our exposure and outcome.” In addition, the investigators failed to include data on the severity of sepsis, features of sepsis treatments, and neuroimaging findings, all of which may possibly play a role in seizure risk. The investigators also noted that patients with sepsis included in this analysis may have presented with other central nervous system (CNS) pathologies that could have contributed to seizure risk.
The investigators of this study believe their findings may “raise the possibility that other acute systemic illnesses may be novel long-term seizure risk factors that have thus far gone unrecognized.”
Reznik ME, Merkler AE, Mahta A, et al. Long-term risk of seizures in adult survivors of sepsis [published online September 6, 2017]. Neurology. doi:10.1212/WNL.0000000000004538