Arquivos de neuro-psiquiatria · 2026
Risk factors for drug-resistant epilepsy according to sex: a cohort study conducted in a middle-income country.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Lagger Ignacio, Pacha Sol, Garino Eliana, Martinez Oscar, Knorre Eduardo, Ernst Glenda
Аннотация
BACKGROUND: Drug-resistant epilepsy (DRE) affects 30% of patients with epilepsy. Although multiple risk factors (RFs) are recognized, there are few studies that explore the differences in clinical presentation, etiology and RFs considering the sex, especially in Latin America.
OBJECTIVE: To analyze sex differences in clinical features, outcomes and RFs for DRE in patients enrolled in 2 hospitals of Buenos Aires between 2020 and 2022.
METHODS: Multicenter retrospective cohort study. Clinical variables, epilepsy characteristics, and complementary studies of patients over 18 years with epilepsy were collected. Descriptive analyses, bivariate comparisons (Chi-squared, t-test/Mann-Whitney U test) and logistic regressions were applied to adjust for confounding factors.
RESULTS: A total of 122 patients were included, of whom 44 had DRE. The prevalence of DRE was slightly higher in men than in women (39.6 vs. 33.3%). Male sex showed 4 RFs for DRE: personal history (odds ratio [OR]: 7.82; 95%CI: 1.54-39.51), magnetic resonance imaging (MRI) with abnormal findings (OR: 4.40; 95%CI: 1.26-15.41), symptomatic etiology (OR: 4.77; 95%CI: 1.44-15.77), and time of evolution (OR: 1.05; 95%CI: 1.00-1.06). In women, time of evolution was the only RF for DRE (OR: 1.04; 95%CI: 1.00-1.08).
CONCLUSION: There are sex differences in clinical, etiological, and imaging features of DRE. It is important to incorporate a sex perspective into the initial assessment, as this could contribute to the early identification of patients with higher risk of DRE. Particularly in men with clinical factors associated with higher risk, it would be advisable to implement earlier and more intensive follow-up strategies.
OBJECTIVE: To analyze sex differences in clinical features, outcomes and RFs for DRE in patients enrolled in 2 hospitals of Buenos Aires between 2020 and 2022.
METHODS: Multicenter retrospective cohort study. Clinical variables, epilepsy characteristics, and complementary studies of patients over 18 years with epilepsy were collected. Descriptive analyses, bivariate comparisons (Chi-squared, t-test/Mann-Whitney U test) and logistic regressions were applied to adjust for confounding factors.
RESULTS: A total of 122 patients were included, of whom 44 had DRE. The prevalence of DRE was slightly higher in men than in women (39.6 vs. 33.3%). Male sex showed 4 RFs for DRE: personal history (odds ratio [OR]: 7.82; 95%CI: 1.54-39.51), magnetic resonance imaging (MRI) with abnormal findings (OR: 4.40; 95%CI: 1.26-15.41), symptomatic etiology (OR: 4.77; 95%CI: 1.44-15.77), and time of evolution (OR: 1.05; 95%CI: 1.00-1.06). In women, time of evolution was the only RF for DRE (OR: 1.04; 95%CI: 1.00-1.08).
CONCLUSION: There are sex differences in clinical, etiological, and imaging features of DRE. It is important to incorporate a sex perspective into the initial assessment, as this could contribute to the early identification of patients with higher risk of DRE. Particularly in men with clinical factors associated with higher risk, it would be advisable to implement earlier and more intensive follow-up strategies.