Chin J Traumatol. 2026 Mar 21:S1008-1275(26)00062-3. doi: 10.1016/j.cjtee.2025.05.008. Online ahead of print.
ABSTRACT
PURPOSE: Traumatic brain injury (TBI) is a severe public health problem worldwide. Early post-traumatic seizures (EPTSs) are acute symptomatic events corresponding to the brain’s response to the physical effects of TBI. Although there are ongoing findings regarding the association between EPTS and TBI, the correlation between EPTS occurrence and the severity of TBI remains unknown. The lack of knowledge regarding such mechanisms can also explain ineffective management. This systematic review and meta-analysis aimed to determine whether EPTS became a predictor of severity in patients with TBI.
METHODS: We performed a meta-analysis between November 2023 – January 2024. The keywords of “Early Post Traumatic Seizure” and “Traumatic Brain Injury” were searched in the PubMed, PMC, Science Direct, Cochrane Library, and Taylor and Francis databases. Only studies published in English were included. If duplicate publications were identified, the study with the larger sample size was selected. The comparison of severe TBI with EPTS was assessed using a Z test.
RESULT: We included 588 TBI patients with EPTS and 1610 patients without EPTS, retrieved from 9 papers. We found that EPTS patients had a 1.170-fold and 0.840-fold increased risk of developing severe TBI in adults (risk ratio: 1.170, 95% confidence interval: 1.000 – 1.370) and pediatric patients (risk ratio: 0.840; 95% confidence interval: 0.380 – 1.840). The research identified no significant evidence of publication bias (p > 0.05) in EPTS data.
CONCLUSION: EPTS are associated with increased severity and may serve as an independent predictor in adult TBI patients; however, this association is not statistically supported in pediatric populations and warrants further investigation.
PMID:41881728 | DOI:10.1016/j.cjtee.2025.05.008
