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Master Thesis

Identification des facteurs de risque de récidive dans les 24 heures du passage aux urgences des patients admis pour crise comitiale

Abstract : Aim: to identify predictors of recurrence within 24 hours of emergency room visits for patients admitted for seizure. Materials and methods: this is a prospective observational 19-month study in three emergency departments, including all adult patients presenting after convulsive seizure episode. A standardize questionnaire was used to collect the variables studied. The primary end point is defined as a recurrence during the first 24h after admission, objectived during the recall at J7. Patients were classified into two groups : first seizure episode and past history of epilepsy or seizures. Results: six hundred and fifty-two patients were included. The median age was 45 ans. The sex ratio was at 1.25. One hundred and thirty-seven patients presented seizure recurrence, it means a rate of 21.01%. An anxiolytic benzodiazepine in patient’s treatment, alcoholism, moderate alcohol withdrawal, positive plasma alcohol and post-critical confusion during the neurological exam were significantly associated with seizure recurrence by univariate analysis in population studied. Surprisingly, others factors like prescription of anticonvulsants (AE or BZP), neurological advice and hospitalization were also significative. For patients with a past history of epilepsy or seizures: more than one seizure per month, moderate alcohol withdrawal, an anxiolytic benzodiazepine in patient’s treatment and post-critical confusion during the neurological exam remained significantly associated on multivariate analysis. Conclusion: further works are needed to establish a guidance decision score for these patients.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02550968
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Submitted on : Wednesday, April 22, 2020 - 4:16:36 PM
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Justine Valieres. Identification des facteurs de risque de récidive dans les 24 heures du passage aux urgences des patients admis pour crise comitiale. Médecine humaine et pathologie. 2018. ⟨dumas-02550968⟩

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