Objective To evaluate the risk factors for seizure recurrence after withdrawal in adult patients with focal epilepsy who have been seizure-free for more than 3 years following drug treatment. Methods This study retrospectively included cases of adult patients with focal epilepsy treated with antiepileptic drugs at the outpatient department of Beijing Tiantan Hospital between January 2018 and October 2024. The chi-square test (or Fisher’s exact test) and logistic regression analysis were used to explore risk factors for seizure recurrence after withdrawal. Results This study analyzed 397 patients with focal epilepsy who maintained seizure-free for more than 3 years with complete clinical data. Among them, 286 patients maintained seizure-free without medication reduction, 2 patients did not reduce medication but experienced recurrence, 73 patients experienced recurrence after medication reduction, and 36 patients remained seizure-free after medication reduction. Among 109 patients with focal epilepsy who withdrew medication after more than 3 years of seizure freedom, 73 (66.97%) experienced recurrence. Univariate analysis revealed no significant correlation between gender, age at onset, comorbidities, or number of antiepileptic drugs and post-withdrawal recurrence (all P > 0.05). Shorter seizure-free duration and abnormal brain MRI findings were identified as risk factors for recurrence after withdrawal (P<0.05). Multivariate logistic regression analysis confirmed that seizure-free duration<4 years and abnormal intracranial lesion were independent risk factors for post-withdrawal recurrence (P<0.05). Conclusions Shorter seizure-free duration and abnormal intracranial lesion are risk factors for seizure recurrence after withdrawal in adult patients with focal epilepsy who have been seizure-free for≥3 years.
Objective To identify the clinical features and risk factors for mortality associated with severe influenza B pneumonia of adults admitted to respiratory intensive care unit (ICU). Methods Patients with confirmed influenza B infection and respiratory failure between February 2020 and February 2022 who were admitted to the ICU were sequentially included. Demographic features, clinical data, microbiological data, complications, and outcomes were collected. Univariate logistic regression analysis was performed to identify risk factors associated with hospital mortality. A comparison with severe influenza A pneumonia was made to explore the characteristics of influenza B virus-associated pneumonia. Results A total of 23 patients with influenza B pneumonia were included. The survival group included 18 patients and the death group included 5 patients, with an ICU mortality of 21.7%. The median age in the death group was 64 (64, 72.5) years, which was significantly older than the survival group, with a median age 59 (30.25, 64.25) years (P=0.030). Univariate logistic regression analysis indicated that SOFA score [odds ratio (OR) 1.307, 95% confidential interval (CI) 1.013 - 1.686, P=0.039], decreased hemoglobin (OR 0.845, 95%CI 0.715 - 0.997, P=0.046), and high blood urea nitrogen (BUN) (OR 1.432, 95%CI 1.044 - 1.963, P=0.026) were independent risk factors for hospital mortality. Compared with influenza A pneumonia, patients with severe influenza B pneumonia had more complications (60.0% vs. 87.0%, P=0.023). Conclusions The mortality of severe influenza B virus-associated pneumonia with was high. Increased SOFA score, anemia, and high BUN were risk factors for ICU mortality of severe influenza B infection in adults.