Liver fibrosis indices associated with substantial hematoma expansion in Chinese patients with primary intracerebral hemorrhage

Abstract Background Whether liver fibrosis is associated with increased risk for substantial hematoma expansion (HE) after intracerebral hemorrhage (ICH) is still uncertain. We evaluated the association between various liver fibrosis indices and substantial HE in a Chinese population with primary ICH. Methods Primary ICH patients admitted to West China Hospital within 24 h of onset between January 2015 and June 2018 were consecutively enrolled. Six liver fibrosis indices were calculated, including aspartate aminotransferase (AST)-platelet ratio index (APRI), AST/alanine aminotransferase ratio-platelet ratio index (AARPRI), fibrosis-4 (FIB-4), modified fibrosis-4 (mFIB-4), fibrosis quotient (FibroQ) and Forns index. Substantial HE was defined as an increase of more than 33% or 6 mL from baseline ICH volume. The association of each fibrosis index with substantial HE was analyzed using binary logistic regression. Results Of 436 patients enrolled, about 85% showed largely normal results on standard hepatic assays and coagulation parameters. Substantial HE occurred in 115 (26.4%) patients. After adjustment, AARPRI (OR 1.26, 95% CI 1.00-1.57) and FIB-4 (OR 1.15, 95% CI 1.02-1.30) were independently associated with substantial HE in ICH patients within 24 h of onset, respectively. In ICH patients within 6 h of onset, each of the following indices was independently associated with substantial HE: APRI (OR 2.64, 95% CI 1.30-5,36), AARPRI (OR 1.55, 95% CI 1.09-2.21), FIB-4 (OR 1.35, 95% CI 1.08-1.68), mFIB-4 (OR 1.09, 95% CI 1.01-1.18), FibroQ (OR 1.08, 95% CI 1.00-1.16) and Forns index (OR 1.37, 95% CI 1.10-1.69). Conclusions Liver fibrosis indices are independently associated with higher risk of substantial HE in Chinese patients with primary ICH, which suggesting that subclinical liver fibrosis could be routinely assessed in such patients to identify those at high risk of substantial HE.

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Liver Fibrosis Indices Associated with Substantial Hematoma Expansion in Chinese Patients with Primary Intracerebral Hemorrhage

10.21203/rs.3.rs-666991/v1 ◽

2021 ◽

Author(s):

Huan Wang ◽

Jiongxing Wu ◽

Xue Yang ◽

Junfeng Liu ◽

Wendan Tao ◽

...

Keyword(s):

Logistic Regression ◽

Liver Fibrosis ◽

Intracerebral Hemorrhage ◽

Chinese Population ◽

Binary Logistic Regression ◽

Chinese Patients ◽

Hematoma Expansion ◽

West China Hospital ◽

West China ◽

Increased Risk

Abstract Background: Whether liver fibrosis is associated with increased risk for substantial hematoma expansion (HE) after intracerebral hemorrhage (ICH) is still uncertain. We evaluated the association between various liver fibrosis indices and substantial HE in a Chinese population with primary ICH.Methods: Primary ICH patients admitted to West China Hospital within 24 hours of onset between January 2015 and June 2018 were consecutively enrolled. Six liver fibrosis indices were calculated, including aspartate aminotransferase (AST)-platelet ratio index (APRI), AST/alanine aminotransferase ratio-platelet ratio index (AARPRI), fibrosis-4 (FIB-4), modified fibrosis-4 (mFIB-4), fibrosis quotient (FibroQ) and Forns index. Substantial HE was defined as an increase of more than 33% or 6 mL from baseline ICH volume. The association of each fibrosis index with substantial HE was analyzed using binary logistic regression. Results: Of 436 patients enrolled, about 85% showed largely normal results on standard hepatic assays and coagulation parameters. Substantial HE occurred in 115 (26.4%) patients. After adjustment, AARPRI (OR 1.26, 95% CI 1.00-1.57) and FIB-4 (OR 1.15, 95% CI 1.02-1.30) were independently associated with substantial HE in ICH patients within 24h of onset, respectively. In ICH patients within 6h of onset, each of the following indices was independently associated with substantial HE: APRI (OR 2.63, 95% CI 1.30-5,34), AARPRI (OR 1.55, 95% CI 1.09-2.22), FIB-4 (OR 1.35, 95% CI 1.08-1.69), mFIB-4 (OR 1.09, 95% CI 1.01-1.18), FibroQ (OR 1.08, 95% CI 1.00-1.16) and Forns index (OR 1.37, 95% CI 1.10-1.69). Conclusions: Liver fibrosis indices are independently associated with higher risk of substantial HE in Chinese patients with primary ICH, which suggesting that subclinical liver fibrosis could be routinely assessed in such patients to identify those at high risk of substantial HE.

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Abstract W P257: Predictors of the CT Angiography Spot Sign in Deep and Lobar Intracerebral Hemorrhage

Stroke ◽

10.1161/str.45.suppl_1.wp257 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Farid Radmanesh ◽

Guido J Falcone ◽

Christopher D Anderson ◽

Thomas W Battey ◽

Alison M Ayres ◽

...

Keyword(s):

Logistic Regression ◽

Intracerebral Hemorrhage ◽

Ct Angiography ◽

Cerebral Amyloid Angiopathy ◽

Symptom Onset ◽

Hematoma Expansion ◽

Amyloid Angiopathy ◽

Spot Sign ◽

Increased Risk ◽

Cerebral Amyloid

Objectives: Intracerebral hemorrhage (ICH) patients with CT angiography (CTA) spot sign are at increased risk of hematoma expansion and poor outcome. Since ICH is often the acute manifestation of a chronic cerebral vasculopathy, we investigated whether different clinical or imaging characteristics predict spot sign presence in patients with different underlying vasculopathies. Using ICH location as a surrogate for hypertension-related ICH and cerebral amyloid angiopathy-related ICH, we identified risk factors associated with spot sign. METHODS: We retrospectively analyzed a prospective cohort of consecutive spontaneous ICH patients with available CTA. Spot sign presence was ascertained by two independent readers blinded to clinical data. We assessed potential predictors of spot sign be performing uni- and multivariable logistic regression, analyzing deep and lobar ICH separately. RESULTS: 649 patients were eligible, 291 (45%) deep and 358 (55%) lobar ICH. Median time from symptom onset to CTA was 4.5 (IQR 5.2) and 5.7 (IQR 7.4) hours in patients with deep and lobar ICH, respectively. At least one spot sign was present in 76 (26%) deep and 103 (29%) lobar ICH patients. In mutivariable logistic regression, independent predictors of spot sign in deep ICH were warfarin (OR 2.82 [95%CI 1.06-7.57]; p=0.03), time from symptom onset to CTA (OR 0.9 [95%CI 0.81-0.97]; p=0.02), and baseline ICH volume (OR 1.27 [95%CI 1.14-1.43]; p=2.5E-5; per 10 mL increase). Predictors of spot sign in lobar ICH were preexisting dementia (OR 2.7 [95%CI 1.15-6.43]; p=0.02), warfarin (OR 4.01 [95%CI 1.78-9.29]; p=0.009), and baseline ICH volume (OR 1.27 [95%CI 1.17-1.39]; p=5.4E-8; per 10 mL increase). As expected, spot sign presence was a strong predictor of hematoma expansion in both deep (OR 3.52 [95%CI 1.72-7.2]; p=0.0005) and lobar ICH (OR 6.53 [95%CI 3.23-13.44]; p=2.2E-7). CONCLUSIONS: The most potent associations with spot sign are shared by deep and lobar ICH, suggesting that ICH caused by different vasculopathic processes share biological features. The relationship between preexisting dementia and spot sign in lobar ICH, but not deep ICH, suggests that ICH occurring in the context of more advanced cerebral amyloid angiopathy may be more likely to have prolonged bleeding.

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Subarachnoid Extension Predicts Lobar Intracerebral Hemorrhage Expansion

Stroke ◽

10.1161/strokeaha.119.028338 ◽

2020 ◽

Vol 51 (5) ◽

pp. 1470-1476 ◽

Cited By ~ 5

Author(s):

Andrea Morotti ◽

Loris Poli ◽

Eleonora Leuci ◽

Federico Mazzacane ◽

Paolo Costa ◽

...

Keyword(s):

Logistic Regression ◽

Intracerebral Hemorrhage ◽

Odds Ratio ◽

Univariate Analysis ◽

Hematoma Expansion ◽

Replication Cohort ◽

Academic Hospitals ◽

Increased Risk ◽

Study Population ◽

Noncontrast Computed Tomography

Background and Purpose— We investigated whether subarachnoid extension (SAHE) of intracerebral hemorrhage (ICH) is associated with hematoma expansion (HE). Methods— Retrospective analysis of patients with primary spontaneous ICH admitted at 3 academic hospitals in Italy. The study population was divided into a development and a replication cohort. SAHE was rated on baseline noncontrast computed tomography by investigators blinded to clinical data. The main outcome of interest was HE, defined as ICH growth >33% mL and/or >6 mL. Predictors of HE were explored with multivariable logistic regression stratified by ICH location (lobar versus nonlobar). Results— A total of 360 and 192 patients were included in the development and replication cohort, respectively. SAHE was identified with good interrater reliability ( K =0.82), and its frequency was 27.8% in the development and 24.5% in the replication cohort. In univariate analysis, HE was more common in patients with SAHE (52.0% versus 27.3%; P <0.001). When controlling for confounders in logistic regression, SAHE was an independent predictor of lobar HE (odds ratio, 6.00 [95% CI, 2.16–16.64]; P =0.001) whereas there was no association with HE in nonlobar ICH (odds ratio, 0.55 [95% CI, 0.17–1.84]; P =0.334). The increased risk of HE in lobar ICH with SAHE was confirmed in the replication cohort (odds ratio, 3.46 [95% CI, 1.07–11.20]; P =0.038). Conclusions— SAHE predicts HE in lobar ICH. This may improve the stratification of HE risk in clinical practice or future trials targeting HE. Further research is needed to confirm our findings and characterize the underlying biological mechanisms.

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SAT0625-HPR FATIGUE AND CONTRIBUTING FACTORS IN CHINESE PATIENTS WITH ANKYLOSING SPONDYLITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.6313 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1272.2-1272

Author(s):

W. Zhou ◽

J. Guo ◽

R. Zhao ◽

C. Dong ◽

Z. Gu

Keyword(s):

Quality Of Life ◽

Logistic Regression ◽

Ankylosing Spondylitis ◽

Sleep Quality ◽

Binary Logistic Regression ◽

The Self ◽

Chinese Patients ◽

Self Rating ◽

Chi Square Analysis

Background:Ankylosing spondylitis (AS) is a systemic chronic inflammatory disease, which most likely occurs in young men. It mainly affects sacroiliac joints, axial skeleton, thoracic cage and seriously decreasing quality of life in AS patients[1,2]. In recent years, fatigue of AS patients has been paid more and more attention[3]. Fatigue is a complex feeling, diseased individuals describe fatigue as a sense of tiredness at rest, exhaustion with activity, lack of energy which affects daily work, inertia or lack of endurance, or as loss of vitality. It has been confirmed that fatigue is not only a symptom but may also be quantified by fatigue scores and can be modified by various measures depending on the underlying cause[4]. However, there has been no study about fatigue in AS patients in China.Objectives:This study aimed to evaluate the predictors of fatigue and the effects of fatigue on HR-QoL among patients with AS.Methods:A total of 150 AS patients were involved in the study. A series of questionnaires included: Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Functional Index (BASFI), the 10 cm Visual Analog Scale (VAS), the Self-Rating Anxiety Scale (SAS), the Self-Rating Depression Scale (SDS), the Pittsburgh Sleep Quality Index (PSQI), the Health Assessment Questionnaire-Disability Index (HAQ-DI), the Short Form 36 Health Survey (SF-36) and the Fatigue Severity Scale(FSS). Independent samples t-test, Mann–Whitney U-test, Chi-square analysis, Pearson /Spearman correlation and binary logistic regression were used to analyze the data.Results:The results demonstrated that 48.7% individuals with AS suffered from fatigue. Compared with AS patients without fatigue, AS patients with fatigue showed higher WHR(P<0.05), increased BASDAI (P<0.01) and poorer BASFI (P<0.05). Meanwhile, AS patients with fatigue tended to have more severe pain(P<0.05), higher degree of anxiety(P=0.001), more serious functional disability(P=0.001) and worse sleep quality(P=0.001). Binary logistic regression indicated that WHR (OR=1.78,P<0.05), BASDAI (OR=1.34,P=0.01), sleep disturbance (OR=2.35,P<0.05) were independent predictors of fatigue in AS patients. Additionally, the occurrence of fatigue significantly reduced the quality of life in AS patients both physically and psychologically.Conclusion:These findings suggested that medical personnel should pay more attention to AS patients with fatigue and take effective measures to relieve fatigue.References:[1]Law L, Beckman Rehnman J, Deminger A, Klingberg E, Jacobsson LTH, Forsblad-d’Elia H (2018) Factors related to health-related quality of life in ankylosing spondylitis, overall and stratified by sex. Arthritis research & therapy 20 (1):284. doi:10.1186/s13075-018-1784-8[2]Hanson A, Brown MA (2017) Genetics and the Causes of Ankylosing Spondylitis. Rheumatic diseases clinics of North America 43 (3):401-414. doi:10.1016/j.rdc.2017.04.006[3]Ulus Y, Akyol Y, Bilgici A, Kuru O (2019) Association of work instability with fatigue and emotional status in patients with ankylosing spondylitis: comparison with healthy controls. Clinical rheumatology 38 (4):1017-1024. doi:10.1007/s10067-018-4366-x[4]Finsterer J, Mahjoub SZ (2014) Fatigue in healthy and diseased individuals. The American journal of hospice & palliative care 31 (5):562-575. doi:10.1177/1049909113494748Acknowledgments:Thanks to all the authors for their efforts and thanks to all members of the Department of Rheumatology of Affiliated Hospital of Nantong University for their helpfulness in the acquisition of data.Disclosure of Interests:None declared

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The association between serum selenium concentration and prognosis in patients with heart failure in a Chinese population

Scientific Reports ◽

10.1038/s41598-021-93873-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Zhiliang Zhang ◽

Chao Chang ◽

Yuxin Zhang ◽

Zhiyong Chai ◽

Jinbei Li ◽

...

Keyword(s):

Heart Failure ◽

Chinese Population ◽

Selenium Concentration ◽

Chinese Patients ◽

Serum Selenium ◽

Increased Risk ◽

Patients With Heart Failure ◽

All Cause Mortality ◽

Serum Selenium Concentration ◽

Baseline Information

AbstractWhether Selenium (Se) deficiency relates with adverse prognosis in Chinese patients with heart failure (HF) is still unknown. This study aimed to investigate the association of serum Se level and the outcomes of patients with HF in a Chinese population. Patients with HF and serum Se examination were retrospectively included. Baseline information were collected at patient’s first admission. The primary and secondary outcomes were all-cause mortality and rehospitalization for HF during follow-up, respectively. The study participants were divided into quartiles according to their serum Se concentrations. The Cox proportional hazard models were adopted to estimate the association of serum Se levels with observed outcomes. A total of 411 patients with HF with a mean age of 62.5 years were included. The mean serum level of Se was 68.3 ± 27.7 µg/L. There was nonsignificant difference of baseline characterizes between the four quartile groups. In comparison with patients in the highest quartile, those with the lowest quartile (17.40–44.35 µg/L) were associated with increased risk of all-cause mortality [adjusted hazard ratios (95% CI) 2.32 (1.43–3.77); Ptrend = 0.001]. Our study suggested that a lower serum Se level was significantly associated with increased risk of all-cause mortality in patients with HF.

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Abstract TP444: Liver Fibrosis is Associated With Hematoma Expansion and 90-Day Mortality in Primary Intracerebral Hemorrhage

Stroke ◽

10.1161/str.50.suppl_1.tp444 ◽

2019 ◽

Vol 50 (Suppl_1) ◽

Author(s):

Neal S Parikh ◽

Hooman Kamel ◽

Babak B Navi ◽

Alexander E Merkler ◽

Jesse Dawson ◽

...

Keyword(s):

Liver Fibrosis ◽

Intracerebral Hemorrhage ◽

Hematoma Expansion

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The Haplotype of the TGFβ1 Gene Associated with Cerebral Infarction in Chinese

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100015365 ◽

2012 ◽

Vol 39 (5) ◽

pp. 626-631 ◽

Cited By ~ 7

Author(s):

Hong-miao Tao ◽

Guo-zhong Chen ◽

Gan-ping Cheng ◽

Xiao-yun Shan

Keyword(s):

Cerebral Infarction ◽

Chinese Population ◽

Transforming Growth Factor ◽

Additive Model ◽

Chinese Patients ◽

Amplification Refractory Mutation System ◽

Strong Linkage Disequilibrium ◽

Nucleotide Polymorphisms ◽

Individual Snps ◽

Increased Risk

Background:Transforming growth factor beta1 (TGFβ1) is a multifunctional cytokine involved in inflammation and pathogenesis of atherosclerosis. The aim of the present study was to investigate the relationship between human TGFβ1 gene +869T>C (rs1800470), -509C>T (rs1800469) single nucleotide polymorphisms (SNPs) and haplotypes and cerebral infarction (CI) in a Chinese population.Methods:The genetic association study was performed in 450 Chinese patients (306 male and 144 female) with CI and 450 control subjects (326 male and 124 female). TGFβ1 gene +869T>C and -509C>T polymorphisms were identified with amplification refractory mutation system polymerase chain reaction and DNA sequencing method.Results:The individual SNPs analysis showed the +869T and -509C in an additive model (+869T vs +869C; -509 C vs T), +869TT genotype in a recessive model (TT vs TC+CC) and 509CC genotype in a dominant model (CC+ CT vs TT) were identified to be related to CI (P<0.05). +869T>C and -509C>T SNPs were in strong linkage disequilibrium (d'=0.87, R2=0.75). Haplotype analysis showed that +869C/-509T haplotype was associated with a significant decreased risk of CI (OR= 0.86, 95%CI, 0.70-0.92; P=0.007). Furthermore,+869T/-509C haplotype was associated with a significant increased risk of CI (OR=1.31, 95%CI, 1.10-2.03; P=0.019).Conclusions:The results of this study indicate that polymorphisms and the haplotypes in the TGFβ1 gene might be genetic markers for CI in the Chinese population.

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A Promoter Region Polymorphism inPDCD-1Gene Is Associated with Risk of Rheumatoid Arthritis in the Han Chinese Population of Southeastern China

International Journal of Genomics ◽

10.1155/2014/247637 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 11

Author(s):

CuiPing Liu ◽

JueAn Jiang ◽

Li Gao ◽

XiaoHan Hu ◽

FengMing Wang ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

T Cells ◽

Chinese Population ◽

Direct Sequencing ◽

Han Chinese ◽

Chinese Patients ◽

Sequencing Analysis ◽

Healthy Controls ◽

Han Chinese Population ◽

Increased Risk

Objective. Programmed cell death 1 (PD-1) induces negative signals to T cells during interaction with its ligands and is therefore a candidate gene in the development of autoimmune diseases such as rheumatoid arthritis (RA). Herein, we investigate the association ofPDCD-1polymorphisms with the risk of RA among Chinese patients and healthy controls.Methods. Using the PCR-direct sequencing analysis, 4PDCD-1SNPs (rs36084323, rs11568821, rs2227982, and rs2227981) were genotyped in 320 RA patients and 309 matched healthy controls. Expression of PD-1 was determined in peripheral blood lymphocytes by flow cytometry and quantitative real-time reverse transcriptase polymerase chain reaction.Results. We observed that the GG genotype of rs36084323 was associated with a increased risk for developing RA (OR 1.70, 95% 1.11–2.61,P=0.049). Patients carrying G/G genotype displayed an increased mRNA level of PD-1(P=0.04)compared with A/A genotype and healthy controls. Meanwhile, patients homozygous for rs36084323 had induced basal PD-1 expression on activated CD4+ T cells.Conclusion. ThePDCD-1polymorphism rs36084323 was significantly associated with RA risk in Han Chinese population. This SNP, which effectively influenced the expression of PD-1, may be a biomarker of early diagnosis of RA and a suitable indicator of utilizing PD-1 inhibitor for treatment of RA.

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Association Between Alkaline Phosphatase and Clinical Outcomes in Patients With Spontaneous Intracerebral Hemorrhage

Frontiers in Neurology ◽

10.3389/fneur.2021.677696 ◽

2021 ◽

Vol 12 ◽

Author(s):

Sijia Li ◽

Wenjuan Wang ◽

Qian Zhang ◽

Yu Wang ◽

Anxin Wang ◽

...

Keyword(s):

Alkaline Phosphatase ◽

Logistic Regression ◽

Intracerebral Hemorrhage ◽

Clinical Outcomes ◽

Functional Outcomes ◽

Adverse Outcomes ◽

Spontaneous Intracerebral Hemorrhage ◽

Mortality And Morbidity ◽

The Third ◽

Increased Risk

Background: Spontaneous intracerebral hemorrhage (ICH) is associated with high rates of mortality and morbidity. Alkaline phosphatase (ALP) is related to increased risk of cardiovascular events and is also closely associated with adverse outcomes after ischemic or hemorrhagic stroke. However, there are limited data about the effect of ALP on clinical outcomes after ICH. Therefore, we aimed to investigate the relationship between serum ALP level and prognosis in ICH patients.Methods: From January 2014 to September 2016, 939 patients with spontaneous ICH were enrolled in our study from 13 hospitals in Beijing. Patients were categorized into four groups based on the ALP quartiles (Q1, Q2, Q3, Q4). The main outcomes were 30-day, 90-day, and 1-year poor functional outcomes (modified Rankin Scale score of 3–6). Multivariable logistic regression and interaction analyses were performed to evaluate the relationships between ALP and clinical outcomes after ICH.Results: In the logistic regression analysis, compared with the third quartile of ALP, the adjusted odds ratios of the Q1, Q2, and Q4 for 30-day poor functional outcome were 1.31 (0.80–2.15), 1.16 (0.71–1.89), and 2.16 (1.32–3.55). In terms of 90-day and 1-year poor functional outcomes, the risks were significantly higher in the highest quartile of ALP compared with the third quartile after adjusting the confounding factors [90-day: highest quartile OR = 1.86 (1.12–3.10); 1-year: highest quartile OR = 2.26 (1.34–3.80)]. Moreover, there was no significant interaction between ALP and variables like age or sex.Conclusions: High ALP level (>94.8 U/L) was independently associated with 30-day, 90-day, and 1-year poor functional outcomes in ICH patients. Serum ALP might serve as a predictor for poor functional outcomes after ICH onset.

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Risk factors for malnutrition in refractory convulsive status epilepticus

10.21203/rs.2.20330/v1 ◽

2020 ◽

Author(s):

Yu Zhang ◽

Deng Chen ◽

Li-na Zhu ◽

ling liu

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Status Epilepticus ◽

Logistic Regression Model ◽

Adverse Outcomes ◽

Convulsive Status Epilepticus ◽

Common Complication ◽

West China Hospital ◽

West China ◽

The Relationship

Abstract Purpose: To study the risk factors and prognosis of malnutrition in patients with refractory convulsive status epilepticus. Methods: A total of 73 patients with refractory convulsive epileptic status in West China Hospital from January 2017 to May 2019 were collected. All patients met the 2016 International Anti-epileptic Alliance diagnostic criteria for refractory convulsive status epilepticus. A logistic regression model was used to evaluate the risk factors of malnutrition in refractory convulsive status epilepticus. Results: Of the 73 patients with refractory convulsive status epilepticus, 33 (45.21%) suffered from malnutrition during hospitalization, and hospitalization days (OR =1.251; 95% CI: 1.067-1.384; P =0.007), nasal feeding (OR =22.623; 95% CI: 1.091-286.899; P =0.013), and malnutrition on admission (OR =30.760; 95% CI: 1.064-89.797; P =0.046) were risk factors for malnutrition in patients with refractory convulsive status epilepticus. Conclusion: Malnutrition is a common complication during hospitalization in patients with refractory convulsive status epilepticus. Hospitalization days, nasal feeding, and malnutrition at admission are risk factors for malnutrition in patients with refractory convulsive status epilepticus. Further longitudinal studies are needed to identify the relationship between refractory convulsive status epilepticus and adverse outcomes.

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