Neuropsychiatric Disease and Treatment (Jul 2021)
Predictive Values of the SeLECT Score and IL-1β for Post-Stroke Epilepsy
Abstract
Lan Shen,1 Jun Yang,2 Yueling Tang1 1Department of Neurology, Central Hospital of Jiangjin District, Chongqing, 402260, People’s Republic of China; 2Department of Critical Care Medicine, Central Hospital of Jiangjin District, Chongqing, 402260, People’s Republic of ChinaCorrespondence: Yueling TangDepartment of Neurology, Central Hospital of Jiangjin District, No. 725, Jiangzhou Road, Dingshan Street, Jiangjin District, Chongqing, 402260, People’s Republic of ChinaTel +86-13667697968Email [email protected]: To establish a new prognostic tool for the prediction of post-stroke epilepsy (PSE) through combining the SeLECT score with IL-1β.Patients and Methods: This prospective observational study included 915 patients with acute ischemic stroke. The SeLECT score was calculated, and serum IL-1β levels were measured within 24 h of their admission. One unprovoked late seizure following the acute phase of stroke was diagnosed as PSE. All patients were divided into PSE group and non-PSE group according to the occurrence of PSE. Multivariate analysis was performed to determine the independent associations between the SeLECT score, IL-1β and PSE. Receiver operating characteristic (ROC) curve was employed to assess the predictive values of the SeLECT score, IL-1β and their combination for PSE.Results: Fifty-three patients occurred PSE within 1 year after stroke onset (5.8%). Multivariate analysis demonstrated that the SeLECT score [odds ratio (OR): 1.416, 95% confidence interval (CI): 1.191– 1.863, P=0.013] and IL-1β (OR: 1.457, 95% CI: 1.215– 1.894, P< 0.001) were independent risk factors for PSE after adjusting for more than one comorbidity, stroke laterality, large-artery atherosclerosis, thrombolysis, age and use of statins. The AUC of the SeLECT score and IL-1β for predicting PSE was 0.756 (SE: 0.033, 95% CI: 0.692– 0.819) and 0.811 (SE: 0.032, 95% CI: 0.748– 0.875), respectively. The AUC of their combination was 0.933 (SE: 0.027, 95% CI: 0.880– 0.985). Z test showed that the AUC of their combination was significantly higher than that of the SeLECT score or IL-1β alone (0.933 vs 0.756, Z=4.151, P< 0.01; 0.933 vs 0.811, Z=2.914, P< 0.01). Combination prediction of the SeLECT score and IL-1β for PSE had a high predictive value with a sensitivity of 88.06% and specificity of 82.37%.Conclusion: The combination of the SeLECT score and IL-1β had a potential to act as a new prognostic tool for the prediction of PSE.Keywords: post-stroke epilepsy, SeLECT score, IL-1β, predictive values
