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Late-onset seizures as a predictor of subsequent stroke
Cleary P, Shorvon S, Tallis R.. Lancet (London, England), 2004-04-01
Topic: Risk, prevention and care in population studies
Unlabelled BACKGROUND Cerebrovascular disease is thought to be a major cause of epilepsy in late life. We investigated the hypothesis that the onset of seizures after the age of 60 years in people with no history of overt stroke might be associated with an increased risk of subsequent stroke. Methods Data were obtained from the UK General Practice Research Database on 4709 individuals who had seizures beginning at or after the age of 60 years, and on 4709 randomly selected controls with no history of seizures, matched for age, sex, and general practice. Individuals with a history of cerebrovascular disease, other acquired brain injury, brain tumour, drug or alcohol misuse, or dementia were not eligible for inclusion. Computerised patients' records were searched for subsequent diagnoses of stroke. Findings Log-rank testing, adjusted for matching, showed a highly significant difference in stroke-free survival between the two groups (p<0.0001). With a Cox's model, we estimated that the relative hazard of stroke at any point for people with seizures compared with the control group was 2.89 (95% CI 2.45-3.41). Interpretation Our findings show that the onset of seizures in late life is associated with a striking increase in the risk of stroke. Further research is warranted to assess the benefit of specific interventions to prevent stroke in patients with seizures.
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APA 7th
Cleary, P., Shorvon, S., & Tallis, R. (2004). Late-onset seizures as a predictor of subsequent stroke. Lancet (London, England). https://doi.org/10.1016/s0140-6736(04)15946-1
Vancouver
Cleary P, Shorvon S, Tallis R. Late-onset seizures as a predictor of subsequent stroke. Lancet (London, England). 2004. doi:10.1016/s0140-6736(04)15946-1. PMID: 15081649.
BibTeX
@article{cleary2004-15081649,
author = {Cleary, P. and Shorvon, S. and Tallis, R.},
title = {{Late-onset seizures as a predictor of subsequent stroke}},
journal = {Lancet (London, England)},
year = {2004},
doi = {10.1016/s0140-6736(04)15946-1},
pmid = {15081649},
url = {https://doi.org/10.1016/s0140-6736(04)15946-1}
}
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Key findings
- We investigated the hypothesis that the onset of seizures after the age of 60 years in people with no history of overt stroke might be associated with an increased risk of subsequent stroke.
- Findings Log-rank testing, adjusted for matching, showed a highly significant difference in stroke-free survival between the two groups (p<0.0001).
- With a Cox's model, we estimated that the relative hazard of stroke at any point for people with seizures compared with the control group was 2.89 (95% CI 2.45-3.41).
- Interpretation Our findings show that the onset of seizures in late life is associated with a striking increase in the risk of stroke.
Study details
- Participants4,709
- Evidence strengthLow
How this study scored 52/100
Published in a top-tier journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 30 of the 58 points we could judge it on, which is 52 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (Lancet (London, England)) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2004 — older than 20 years, still counted |
| Sample size | 3 / 4 | 4,709 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 15081649) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 30 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 30 of the 58 points we could judge it on is 52 out of 100. |
| Total | 52 / 100 | — |
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