De novo status epilepticus is associated with adverse outcome: An 11-year retrospective study in Hong Kong.

Autor: Lui HK; Department of Medicine, Tseung Kwan O Hospital, Hong Kong, China. Electronic address: katelui88@yahoo.com.hk., Hui KF; Department of Medicine, Tseung Kwan O Hospital, Hong Kong, China., Fong WC; Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China., Ip CT; Department of Medicine, Tseung Kwan O Hospital, Hong Kong, China., Lui HT; Department of Medicine, Tseung Kwan O Hospital, Hong Kong, China; Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China.
Jazyk: angličtina
Zdroj: Seizure [Seizure] 2016 Aug; Vol. 40, pp. 42-5. Date of Electronic Publication: 2016 Jun 14.
DOI: 10.1016/j.seizure.2016.06.006
Abstrakt: Purpose: To identify predictors of poor clinical outcome in patients presenting to the intensive care units with status epilepticus (SE), in particular for patients presenting with de novo status epileptics.
Methods: A retrospective review was performed on patients admitted to the intensive care units with status epilepticus in two hospitals in Hong Kong over an 11-year period from 2003 to 2013.
Results: A total of 87 SE cases were analyzed. The mean age of patients was 49.3 years (SD 14.9 years). Eighteen subjects (20.7%) had breakthrough seizure, which was the most common etiology for the status epilepticus episodes. Seventy-eight subjects (89.7%) had convulsive status epilepticus (CSE) and 9 subjects (10.3%) had non-convulsive status epilepticus (NCSE) on presentation. The 30-day mortality rate of all subjects was 18.4%. Non-convulsive status epilepticus was more common in patients with de novo status epilepticus when compared to those with existing history of epilepsy (15.5% Vs. 0%, p=0.03). Patients with de novo status epilepticus were older (52 Vs 43, p=0.009). De novo status epilepticus was associated with longer status duration (median 2.5 days, IQR 5 days), longer ICU stay (median 7.5 days, IQR 9 days) and poorer outcome (OR 4.15, 95% CI 1.53-11.2).
Conclusions: For patients presenting to intensive care units with status epilepticus, those with de novo status epileptics were older and were more likely to develop non-convulsive status epilepticus. De novo status epilepticus was associated with poorer outcome. Continuous EEG monitoring would help identifying NCSE and potentially help improving clinical outcomes.
(Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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