Incidence and predictors of early post-stroke seizures among adult stroke patients at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: a retrospective cohort study

Stroke is a sudden neurological deficit of the brain due to vascular cause. A seizure is a transient clinical condition resulting from abnormal excessive neuronal activity in the brain. Early seizures might complicate the clinical course of patients with acute stroke, including an increase in infarct size and impaired functional recovery. There is scarce evidence on the magnitude and predictors of early post stroke seizures in Ethiopia. This study aimed to determine the incidence and predictors of early seizures among stroke patients in a hospital setting, Northwest Ethiopia. An institution-based retrospective cohort study was conducted from February 1, 2024 to May 31, 2024 for the study period between January 1, 2020 and December 31, 2023 at the University of Gondar hospital. Early post-stroke seizures were defined as seizures that occur within the first 7 days of stroke onset. Convenience sampling method was used to recruit 384 study subjects. Medical records of study subjects were reviewed and data were extracted using a data extraction format. Data were entered into Epi data version 4.6 (Epi Info, Atlanta, USA) and then exported to Stata version 18.5 statistical software (StataCorp, Texas, USA) for analysis. Binary logistic regression model was used to identify associated variables of early post-stroke seizures. A P-value < 0.05 was used to declare a significant association. The median age of study subjects was 65 (IQR = 54–73) years, and majority (57%) of study participants were males. The incidence of early post-stroke seizures was 8.6% (95% CI 6.16–11.85%). Hemorrhagic stroke (AOR = 4.63, 95% CI 1.28–16.66), elevated intracranial pressure (AOR = 3.24, 95% CI 1.07–9.78), higher National Institute of Health Stroke Scale (NIHSS) score (AOR = 1.25, 95% CI 1.14–1.36), hypertension (AOR = 4.88, 95% CI 1.39–17.14), and atrial fibrillation (AOR = 6.94, 95% CI 1.84–26.18) were identified as predictors of early post-stroke seizures. The incidence of early post-stroke seizures was found to be within global reports. Hemorrhagic stroke, high NIHSS score, raised intracranial pressure (ICP), hypertension and atrial fibrillation were significantly associated with the development of early post-stroke seizures. Healthcare practitioners should recognize early and treat promptly identified risk factors to prevent the untoward effects of early post-stroke seizures.