Publications by authors named "Alain Lekoubou"
This study examines the relationship between comorbid seizures and dementia among stroke patients using the 2017 Nationwide Inpatient Sample (NIS), the largest publicly available inpatient healthcare database in the United States. We analyzed data from 128,341 stroke patients, including those with ischemic and hemorrhagic strokes, to determine the prevalence of seizures and dementia, and the association between these conditions. Our findings reveal that 7.
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- The study examines the rising rates of spontaneous intracerebral hemorrhage (sICH) and acute seizure (AS) among young Americans (aged 18-64) from 2005 to 2015, finding an increase in AS incidence during this period.
- Using a large database, researchers identified trends in AS incidence and its association with in-hospital mortality, finding AS incidence rose from 8.1% to 11.0% over the decade.
- The study concludes that while overall in-hospital mortality decreased for those without AS, mortality for those with AS remained stable, and individuals with AS were 10% more likely to die than those without it.
Article Synopsis
- Intracerebral hemorrhage accounts for 15% of strokes and is linked to a significant risk of developing post-stroke epilepsy, but current predictive models for seizures are unreliable and underutilize available real-world data and AI technology.
- This study analyzes patients with intracerebral hemorrhage from 2015 to 2022 to develop machine-learning models that aim to predict seizure occurrence at 1 and 5 years after the hemorrhage.
- Results showed that out of a cohort of 85,679 patients, 4.57% experienced seizures within 1 year and 6.27% within 5 years, indicating a need for more effective prediction methods.
Article Synopsis
- The study aims to create a machine learning model that predicts the risk of seizures after ischemic stroke (IS) using a large dataset from Electronic Health Records, serving as a tool for clinical decision-making.
- Seizures often occur post-stroke and can negatively impact patient outcomes, making it essential to distinguish between high and low-risk individuals to improve treatment and clinical trial strategies.
- The study analyzed 430,254 IS patients and found 4.3% had seizures within 1 year and 5.3% within 5 years, using metrics like AUROC to evaluate the model's prediction performance, achieving various accuracy levels.
Purpose Of Review: This review aims at providing updates on selected post-stroke complications. We examined recent advances in diagnosing and treating the following post-stroke complications: cognitive impairment, epilepsy, depression, fatigue, tremors, dysphagia, and pain.
Recent Findings: Advances in understanding the mechanisms of post-stroke complications, in general, are needed despite advances made in understanding, treating, and preventing these complications.
Background And Purpose: Cerebral microbleeds (CMBs), markers of small vessel disease are frequent in ischemic stroke, yet the association with acute symptomatic seizures (ASS) has not been well characterized.
Methods: A retrospective cohort of hospitalized patients with anterior circulation ischemic stroke. The association of CMBs with acute symptomatic seizures was assessed using a logistic regression model and causal mediation analysis.
(1) Background: Epilepsy is one of the most common chronic neurological disorders in childhood. Complementary and alternative medicine (CAM) use is highly prevalent in patients with epilepsy. Despite CAM's widespread and increasing popularity, its prevalence, forms, perceived benefits, and potential risks in pediatric epilepsy are rarely explored.
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- Mechanical Thrombectomy (MT) is commonly used to treat Acute Ischemic Stroke (AIS) caused by large vessel occlusions, but it can lead to seizures as a complication.
- A study analyzing data from 2006 to 2014 identified that 4.5% of AIS patients who underwent MT had seizures, with younger, privately insured, or Medicaid patients being more affected.
- Seizures significantly increased the odds of in-hospital mortality by nearly 75%, highlighting the need for awareness and tracking of seizure risks in future stroke treatments.
Rationale: Epilepsy is a frequent neurologic condition with important financial strains on the US healthcare system. The co-occurrence of multiple chronic conditions (MCC) may have additional financial repercussions on this patient population. We aimed to assess the association of coexisting chronic conditions on healthcare expenditures among adult patients with epilepsy.
View Article and Find Full Text PDFDecompressive hemicraniectomy for stroke by race/ethnicity in the United States.
eNeurologicalSci
December 2022
Objective: Racial and ethnic differences in the performance of indicated neurosurgical procedures have been reported. However, it is not clear whether there are racial or ethnic differences in the performance of decompressive hemicraniectomy (DHC) for acute ischemic stroke. This study evaluated the rate, trends, and independent association of race and ethnicity with DHC among hospitalized ischemic stroke patients in the United States.
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- Stroke is the leading cause of epilepsy in older adults, yet there's limited nationwide data on how convulsive status epilepticus (CSE) affects mortality in hospitalized elderly stroke patients in the U.S.
- An analysis of the National Inpatient Sample from 2006-2014 revealed that 0.14% of elderly stroke patients had CSE, with a significantly higher in-hospital mortality rate of 25.8% compared to 7.7% for those without CSE.
- CSE was found to independently increase the odds of in-hospital death by four times, alongside factors like increased age and comorbidities affecting survival rates.
Background: Neural tube defects (NTDs) are associated with high rates of neonatal mortality and morbidity worldwide. The promotion of folic acid fortification and supplementation in pregnant women by the Food and Drug Administration significantly decreased the incidence of NTDs in the United States. This practice is not widely adopted in Eastern Africa countries.
View Article and Find Full Text PDFBackground And Objectives: The effect of new-onset seizures in young stroke survivors on the subsequent development of dementia is poorly understood. This study aimed to assess the association between new onset of seizure and dementia in a population-based study of patients with stroke.
Methods: The IBM Watson Health MarketScan Commercial Claims and Encounters database for the years 2005-2014 served as the data source for this study.
Prevalence and Predictors of Stroke in Patients with Crohn's Disease: A Nationwide Study.
J Stroke Cerebrovasc Dis
February 2022
Article Synopsis
- The study investigates the link between Crohn's disease (CD) and increased risk of ischemic stroke (IS), highlighting the microbiome's role in neurological conditions.
- Analysis of the 2017 Nationwide Inpatient Sample data reveals that about 1.2% of CD patients experienced IS, with factors like older age, high income, and specific hospital locations increasing risk.
- The findings identify traditional risk factors such as atrial fibrillation and hypertension, suggesting that CD patients with these conditions should receive targeted monitoring and preventive care for stroke.
Importance: Short-term and long-term persistent postacute sequelae of COVID-19 (PASC) have not been systematically evaluated. The incidence and evolution of PASC are dependent on time from infection, organ systems and tissue affected, vaccination status, variant of the virus, and geographic region.
Objective: To estimate organ system-specific frequency and evolution of PASC.
Article Synopsis
- - The study investigates hospitalization patterns for generalized convulsive status epilepticus (GCSE) in the U.S. and identifies factors that lead to longer hospital stays.
- - An analysis of data from over 57,000 patients revealed that 42.1% had hospital stays of seven days or more, with older age, female gender, minority status, and certain medical conditions linked to longer stays.
- - The findings suggest that strategies to reduce hospital lengths of stay for GCSE should target specific patient demographics and health factors to be effective.
Racial Disparities in Ischemic Stroke Among Patients with COVID-19 in the United States.
J Stroke Cerebrovasc Dis
August 2021
Background: Cerebrovascular prevalence is high in patients with coronavirus disease 2019 (COVID-19). However, whether racial disparities exist among this population have not been systematically explored.
Methods: We performed a retrospective study to assess the prevalence of stroke stratified by race among patients aged 18 years or older with COVID-19 who visited emergency department (ED) up to August 13, 2020 in the United States (US).
Objective: Certain antiepileptic drugs are associated with an increased risk for major congenital malformations (MCM). However, little is known regarding recent patterns of antiepileptic drug (ASM) prescriptions to women of childbearing age with epilepsy (WCE) in the United States.
Methods: Data from the Medical Expenditure Panel Survey was analyzed between the years 2004-2015 to determine trends in national antiepileptic drug prescriptions for WCE.
Background And Purpose: We performed a systematic review to evaluate available risk models to predict late seizure onset among stroke survivors.
Methods: We searched major databases (PubMed, SCOPUS, and Cochrane Library) from inception to October 2020 for articles on the development and/or validation of risk models to predict late seizures after a stroke. The impact of models to predict late-onset seizures was also assessed.
Objective: To assess the relationship between generalized convulsive status epilepticus (GCSE) during an index stroke hospitalization and occurrence of 30-day hospital readmission.
Methods: Retrospective analysis of data within the 2014 National Readmission Database, a national dataset tracking readmissions in the United States. We identified patients with an index discharge diagnosis of stroke using the International Classification of Disease, Ninth Revision, Clinical Modification (433.