老年人首次癫痫发作后90天死亡相关危险因素分析

目的探讨老年人首次癫痫发作后90 d内死亡相关危险因素，以期指导临床预后评估。 方法选取2010至2018年浙江医院收治的首次癫痫发作的65岁以上老年患者93例，收集患者的一般资料、常规脑电图特点、用药情况等。采用SPSS软件进行单因素和多因素logistic回归分析，筛选出与90 d内死亡风险有关的危险因素。 结果单因素回归分析提示，年龄、首发癫痫持续状态、肺部疾病、脑电图改变是90 d内死亡的危险因素（t=1.986，χ²=4.550、6.299、5.771；均P<0.05）；多因素回归分析校正后发现，仅年龄是老年人首次癫痫发作90 d内死亡的危险因素（OR=1.089，95%CI=1.025-1.157，P<0.05）；单因素及多因素回归分析均提示，地西泮针的使用是老年人首次癫痫发作后90 d死亡的保护性因素（OR=0.189，95%CI=0.071-0.505；OR=0.255，95%CI=0.081-0.811；P<0.05）。 结论年龄是老年人首次癫痫发作后90 d内死亡的独立危险因素，早期使用地西泮针可能有保护作用。

Analysis of risk factors related to death 90-day after first seizure attack in the elderly

ObjectiveTo explore the risk factors related to death 90-day after first seizure attack in the elderly, in order to guide the clinical prognosis evaluation. MethodsFrom 2010 to 2018, 93 elderly patients over 65 years old admitted to zhejiang hospital with the first seizure were selected to collect the general clinical data, routine eeg characteristics and medication status of the patients. SPSS software was used for univariate and multivariate logistic regression analysis, and the risk factors related to death risk within 90 days were screened out. ResultsUnivariate regression analysis showed that age, first epileptic status, lung disease and electroencephalogram were the risk factors of death within 90 days (t=1.986, χ²=4.550, 6.299, 5.771, all P<0.05). After adjustment for multivariate regression analysis, it was found that only age was the risk factor of death within 90 days (OR=1.089, 95%CI=1.025-1.157, P<0.05). Whether single factor regression analysis or multi factor regression analysis, it was suggested that diazepam injection was a protective factor for the death of the elderly 90 days after the first seizure (OR=0.189, 95%CI=0.071-0.505; OR=0.255, 95%CI=0.081-0.811, all P<0.05). ConclusionAge is an independent risk factor for death within 90 days after the first seizure in the elderly, and early use of diazepam may have a protective effect.