AUTHOR=Pan Zhiming , Zhong Qiuli , Wang Chaoying , Wang Jianqun , Chen Xiaoyan , Li Xiaoyan , Zhang Xintong , Zhang Yibin 

TITLE=Association Between Partial Pressure of Carbon Dioxide and Immediate Seizures in Patients With Primary Intracerebral Hemorrhage: A Propensity-Matched Analysis

JOURNAL=Frontiers in Neurology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.865207

DOI=10.3389/fneur.2022.865207

ISSN=1664-2295

ABSTRACT=<sec><title>Purpose</title><p>To explore the value of partial pressure of carbon dioxide (PaCO<sub>2</sub>) levels in arterial blood for predicting immediate seizures (ISs) in patients with primary intracerebral hemorrhage (ICH).</p></sec><sec><title>Methods</title><p>Demographic information and clinical data from patients with primary ICH were prospectively collected, including arterial blood gas analysis. Immediate seizures (ISs) were determined as seizures in the first 24 h after admission. Univariate and multivariate analyses were performed to assess the association of PaCO<sub>2</sub> levels with ISs. Propensity-score matching (PSM) analyses were adopted to reduce the baseline difference between ISs and non-ISs groups.</p></sec><sec><title>Results</title><p>A total of 596 patients with primary ICH were initially screened in this clinical study, 368 of whom fulfilled all the inclusion criteria [mean age, (60.46 ±12.78) years; 57.9% female patients]. ISs occurred in 30 of the 368 (8.15%) patients with primary ICH of this cohort. Patients with ISs had significantly lower PaCO<sub>2</sub> levels [34.35(32.38–37.53) vs. 39.45(35.90–43.43), mmHg, <italic>p</italic> &lt; 0.001] and were younger than those without ISs [(54.57±12.15 vs. 60.99 ±12.72) years, <italic>p</italic> = 0.008]. Multivariate analysis showed that lower initial PaCO<sub>2</sub> (≤37.2 mmHg) level was a significant independent predictor of ISs [odds ratios (OR) 0.141, 95% confidence interval (CI) 0.057–0.351, <italic>p</italic> &lt; 0.001], as well as younger age (OR 0.961, 95% CI 0.928–0.995, <italic>p</italic> = 0.023) and hematoma expansion (OR 0.340, 95% CI 0.134–0.863, <italic>p</italic> = 0.023). Receiver operating characteristic curve (ROC) analysis demonstrated that the optimal cutoff value of PaCO<sub>2</sub> level for predicting ISs was 37.20 mmHg in patients with primary ICH (the area under the curve (AUC) was 0.760 with a corresponding sensitivity of 76.67% and specificity of 67.46%, 95%CI = 0.713–0.802, <italic>p</italic> &lt; 0.001). After PSM, the matched ISs group had significantly lower PaCO<sub>2</sub> levels compared with the matched non-ISs group [34.45(32.43–38.18) vs. 41.75(35.85–43.98) mmHg, <italic>p</italic> &lt; <italic>0</italic>.05] in the univariate analysis. The lower initial PaCO<sub>2</sub> level was still independent of ISs following primary ICH.</p></sec><sec><title>Conclusions</title><p>The lower initial PaCO<sub>2</sub> level was associated with an increased risk of ISs in patients with primary ICH.</p></sec>