Factors Affecting the Recurrence of Seizure in Children with Developmental Disorders Using Frailty Model for Recurrent Event and Considering Restraint Period

Authors

  • Ahangari Saryazdi, Saeed MSc. Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
  • Bakhshi, Enayatollah Associate Professor, Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
  • Hosseinzadeh, Samaneh Assistant Professor, Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
  • Rahgozar, Mehdi Associate Professor, Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
  • Shahrolhi, Amin PhD. Pediatric Neurological Rehabilitation Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Abstract:

Objective: Seizure is the most common neurological disorder in pediatric medicine. This disorder is often chronic and requires continuous treatment. Developmental disorders are conditions that can occur due to abnormal development or damage to the brain and central nervous periods (out-of-hospital). However, in most studies, the severity of seizure relapse is mistakenly considered the same for each period. The present study aimed to identify  factors related to the recurrence of seizure in children with developmental disorder. Materials & Methods: In this retrospective cohort study, 228 children with developmental disorder and a history of seizures referred to the emergency department of the Children’s Hospital Medical Center in Tehran, Iran in 2016. Relapse times, admission duration and discharge time, age, sex, birth weight, type of delivery, parental relatives, maternal age during pregnancy, mother's history of medication use and disease during pregnancy, history of seizure with fever, family history of seizure, maternal delivery problems, length of pregnancy, history of admission to neonatal intensive care unit were recorded as factors affecting recurrence of seizure. Inclusion criteria were having developmental disorder and a history of seizure recurrence. The patients who were hospitalized for any reason other than seizure were excluded from the study. No intervention was performed in this study. Patients' information was recorded with their permission and based on ethical principles and the results were presented in the form of tables. Survival model was used to investigate the effect of risk factors on the seizure recurrence. If the seizure recurrence in children was controlled in hospital by medical staff, response variable (relapse time) was considered as censored. A frailty parameter was used to explain the correlation between recurrence of seizures in one subject, and a correlation parameter was used to justify the difference in in the rate of correlation between seizures in a hospital and in somewhere other than hospital. The collected data were analyzed using frailty model for recurrent event by considering restraint period. To achieve an effective and flexible approximation for estimating base intensities, the piecewise constant intensity method was used. Estimation of the parameters was performed using the Gaussian quadrature method and by NLMIXED procedure in SAS v. 9.2 software. Results: Of 228 children, 125 (54.8%) were boys and half of them were under 3 years of old. The mothers of 200 children (87.72%) had age of 18-35 years at the time of pregnancy; 96 (41.67%) of these patients were admitted to neonatal intensive care unit during neonatal period. The birth weight of 199 (28.27%) children was about 2.5-4 kg and 119 did not experience any seizure during the restraint period (in the hospital). The frequency of seizure recurrence in hospital ranged from 1 (25.88%) to 16 times (0.44%), while in out-of-hospital, it ranged from 1 (7.46%) to 11 times (0.44%). The duration of seizure recurrence was between 1 to 6196 days. Furthermore, children aged 1-2 years (P<0.001) with a history of admission to neonatal intensive care unit (P<0.001) whose mothers were 18-35 years of old during pregnancy (P=0.022) experienced more out-of-hospital seizure recurrence, while children aged 1-2 years (P=0.007) with a birth weight of 2.5-4 kg (P= 0.037) experienced less seizure recurrence in hospital. Conclusion: Considering the meaningful relationships and appropriate planning, the recurrence of seizure can be reduced in children with developmental disorder during hospitalization or after withdrawal.

Upgrade to premium to download articles

Sign up to access the full text

Already have an account?login

similar resources

the use of appropriate madm model for ranking the vendors of mci equipments using fuzzy approach

abstract nowadays, the science of decision making has been paid to more attention due to the complexity of the problems of suppliers selection. as known, one of the efficient tools in economic and human resources development is the extension of communication networks in developing countries. so, the proper selection of suppliers of tc equipments is of concern very much. in this study, a ...

15 صفحه اول

a framework for identifying and prioritizing factors affecting customers’ online shopping behavior in iran

the purpose of this study is identifying effective factors which make customers shop online in iran and investigating the importance of discovered factors in online customers’ decision. in the identifying phase, to discover the factors affecting online shopping behavior of customers in iran, the derived reference model summarizing antecedents of online shopping proposed by change et al. was us...

15 صفحه اول

Multivariate Frailty Modeling in Joint Analyzing of Recurrent Events with Terminal Event and its Application in Medical Data

Background and Objectives: In many medical situations, people can experience recurrent events with a terminal event. If the terminal event is considered a censor in this type of data, the assumption of independence in the analysis of survival data may be violated. This study was conducted to investigate joint modeling of frequent events and a final event (death) in breast cancer patients using ...

full text

diagnostic and developmental potentials of dynamic assessment for writing skill

این پایان نامه بدنبال بررسی کاربرد ارزیابی مستمر در یک محیط یادگیری زبان دوم از طریق طرح چهار سوال تحقیق زیر بود: (1) درک توانایی های فراگیران زمانیکه که از طریق برآورد عملکرد مستقل آنها امکان پذیر نباشد اما در طول جلسات ارزیابی مستمر مشخص شوند; (2) امکان تقویت توانایی های فراگیران از طریق ارزیابی مستمر; (3) سودمندی ارزیابی مستمر در هدایت آموزش فردی به سمتی که به منطقه ی تقریبی رشد افراد حساس ا...

15 صفحه اول

My Resources

Save resource for easier access later

Save to my library Already added to my library

{@ msg_add @}


Journal title

volume 20  issue 4

pages  360- 375

publication date 2019-12

By following a journal you will be notified via email when a new issue of this journal is published.

Keywords

No Keywords

Hosted on Doprax cloud platform doprax.com

copyright © 2015-2023