ArticleStroke2023
Comparative Effectiveness and Safety of Seizure Prophylaxis Among Adults After Acute Ischemic Stroke.
Article in Stroke, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 15 citations in OpenAlex.
- Seizure Rates in Mild and Moderate Traumatic Brain Injury With Intracranial Hemorrhage: A Signal for Prospective Investigation of Seizure Prophylaxis in Moderate TBI.World journal of surgery · 2026Article
- Treatment Patterns of Antiseizure Medication for Poststroke Prophylaxis Among Older Adults.Journal of the American Heart Association · 2026Article
- Choice of antiseizure medications and associated outcomes in Medicare beneficiaries after acute ischemic stroke.Epilepsia · 2025Article
- Navigating pediatric post-stroke epilepsy: comparative assessment of treatment strategies.Acta neurologica Belgica · 2025Article
- Initiation of Antiseizure Medications in Patients With Brain Abscess.JAMA network open · 2025Article
- Differences in patterns of outpatient epilepsy-specific medication initiation after acute ischemic stroke in the Medicare population.Epilepsia · 2025Observational
- Benzodiazepine Initiation and the Risk of Falls or Fall-Related Injuries in Older Adults Following Acute Ischemic Stroke.Neurology. Clinical practice · 2025Article
- Choice of Epilepsy Anti-Seizure Medications and Associated Outcomes in Medicare Beneficiaries.medRxiv : the preprint server for health sciences · 2025Article
- Antiseizure medications for primary and secondary seizure prevention after stroke.Frontiers in neurology · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundOlder adults occasionally receive seizure prophylaxis in an acute ischemic stroke (AIS) setting, despite safety concerns. There are no trial data available about the net impact of early seizure prophylaxis on post-AIS survival.
methodsUsing a stroke registry (American Heart Association's Get With The Guidelines) individually linked to electronic health records, we examined the effect of initiating seizure prophylaxis (ie, epilepsy-specific antiseizure drugs) within 7 days of an AIS admission versus not initiating in patients ≥65 years admitted for a new, nonsevere AIS (National Institutes of Health Stroke Severity score ≤20) between 2014 and 2021 with no recorded use of epilepsy-specific antiseizure drugs in the previous 3 months. We addressed confounding by using inverse-probability weights. We performed standardization accounting for pertinent clinical and health care factors (eg, National Institutes of Health Stroke Severity scale, prescription counts, seizure-like events).
resultsThe study sample included 151 patients who received antiseizure drugs and 3020 who did not. The crude 30-day mortality risks were 219 deaths per 1000 patients among epilepsy-specific antiseizure drugs initiators and 120 deaths per 1000 among noninitiators. After standardization, the estimated mortality was 251 (95% CI, 190-307) deaths per 1000 among initiators and 120 (95% CI, 86-144) deaths per 1000 among noninitiators, corresponding to a risk difference of 131 (95% CI, 65-200) excess deaths per 1000 patients. In the prespecified subgroup analyses, the risk difference was 52 (95% CI, 11-72) among patients with minor AIS and 138 (95% CI, 52-222) among moderate-to-severe AIS patients. Similarly, the risk differences were 86 (95% CI, 18-118) and 157 (95% CI, 57-219) among patients aged 65 to 74 years and ≥75 years, respectively.
conclusionsThere was a higher risk of 30-day mortality associated with initiating versus not initiating seizure prophylaxis within 7 days post-AIS. This study does not support the role of seizure prophylaxis in reducing 30-day poststroke mortality.
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Registered trials
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