Analysis Of Risk Factors And Establishment Of Early Warning Model For Secondary Epilepsy In Cerebral Infarction Patients

Objective:We analyze the risk factors of secondary epilepsy in patients with cerebral infarction,and built an early warning model of secondary epilepsy in patients with cerebral infarction for early prevention and early recognition,so as to improve the prognosis of such patients.Methods:We collect Clinical data of 120 patients with cerebral infarction.They included gender,age,smoking history,diabetes mellitus,hypertension,atrial fibrillation,hyperhomocysteinemia,electrolyte level(potassium,sodium,chlorine,calcium),infarct site(cortical,subcortical),cerebral infarction classification(cardiogenic,non-cardiogenic),involved arterial system(internal carotid circulation system,basilar circulation system),and NIHSS Score(<15,≥15)and blood infiltration after cerebral infarction.Patients with secondary epilepsy were taken as the mutual control.60 patients with secondary epilepsy were included in the case group,the case group included 42 males and 18 females,and the control group included 60 patients without secondary epilepsy,including 38 males and 22 females.To use Logistic regression model to analyze related data and use ROC curve to analyze the effectiveness of risk prediction.Results:1.There were no statistically significant differences between the two groups in age,sex,smoking history,hyperhomocysteinemia,hypertension,diabetes,atrial fibrillation,and normal serum electrolyte indexes(P>0.05).2.The results of univariate analysis showed that the proportion of cardiogenic cerebral infarction,the proportion of cortical lesion site,the proportion of internal carotid circulation artery involved,the proportion of extravasation after cerebral infarction and the proportion of NIHSS score greater than 15 points in the case group were higher than those in the control group,with statistical significance(P<0.05).Unconditioned Logistic regression analysis suggested that the patients had cardiogenic cerebral infarction(OR:3.987,95%CI: 1.477,10.764),cortical lesions(OR: 6.216,95%CI: 2.281,16.944),and internal carotid circulatory system involvement(OR: 5.757,95%CI: 1.684,19.681),extravasation after cerebral infarction(OR: 8.866,95%CI: 2.147,36.615),NIHSS score > 15(OR:4.138,95%CI: 1.529,11.201)were risk factors for secondary epilepsy after cerebral infarction(P<0.05).3.According to the results of binary logistic regression analysis,the regression equation of the model was obtained as logit(p)=-3.780+1.383× cerebral infarction type(0)= non-cardiogenic cerebral infarction,1= cardiogenic cerebral infarction)+1.827×focal site [0= subcortical(basal ganglia),1= cortex(lobe)]+1.750× involved artery [0=posterior circulation(vertebrobasilar circulation),1= anterior circulation(internal carotid artery circulation)]+2.182× post-infarction bleeding(0= no,1= yes)+1.420×NIHSS score(0= less than or equal to 15 points,1= more than 15 points).The area under ROC curve of the early-warning model of secondary epilepsy in cerebral infarction patients was 0.874,95%CI was(0.812,0.937),P<0.001.Conclusion:The incidence rate of secondary epilepsy is higher in patients with cerebral infarction,and the risk of secondary epilepsy is greater in patients with cerebral infarction,the focal site is cortical,the affected artery is internal carotid circulation,the bleeding after cerebral infarction and the NIHSS score is greater than 15,which suggests that doctors should pay attention to the early warning and prevention of epilepsy complications in clinical work.The early warning model of epilepsy secondary to cerebral infarction can provide a basis for clinical observation,prevention and treatment of epilepsy complications.