[Adequacy and effect of preventive antiepileptic treatment after a first epileptic seizure 30 days after discharge from hospital emergency departments: the ACESUR registry].

Autor: Linan-Lopez M; Hospital Universitario Virgen de las Nieves, 18013 Granada, Espana.; Sociedad Espanola de Medicina de Urgencias y Emergencias (SEMES), Madrid, Espana., Fernandez-Alonso C; Hospital Clinico San Carlos, 28035 Madrid, Espana.; Sociedad Espanola de Medicina de Urgencias y Emergencias (SEMES), Madrid, Espana., Gonzalez-Martinez F; Hospital Virgen de la Luz, Cuenca, Espana.; Sociedad Espanola de Medicina de Urgencias y Emergencias (SEMES), Madrid, Espana., Fuentes-Ferrer M; Hospital Clinico San Carlos, 28035 Madrid, Espana., Alonso-Aviles R; Hospital Clinico Universitario, 47005 Valladolid, Espana.; Sociedad Espanola de Medicina de Urgencias y Emergencias (SEMES), Madrid, Espana., Martinez-Alvarez S; Hospital Universitario La Paz, Madrid, Espana.; Sociedad Espanola de Medicina de Urgencias y Emergencias (SEMES), Madrid, Espana., En Representacion Del Grupo Acesur ERDGA
Jazyk: Spanish; Castilian
Zdroj: Revista de neurologia [Rev Neurol] 2019 Sep 01; Vol. 69 (5), pp. 181-189.
DOI: 10.33588/rn.6905.2018510
Abstrakt: Aim: To evaluate the adequacy and effect of preventive antiepileptic treatment in adult patients with the first epileptic seizure in adverse outcomes at 30 days after discharge from the hospital emergency department (HED).
Patients and Methods: ACESUR was an observational registry of multipurpose, prospective and multicentric cohorts with a systematic sampling. Phone follow-up was done at 30 days. Clinical variables were collected in the index visit and the follow-up result. The main variable was «adequate preventive treatment according to indications» and the result of «some adverse outcome» (recurrence of epileptic seizure, revisits to HED, hospitalization or death) 30 days after discharge from HED. A logistic regression model was used to isolate the effect of adequate preventive treatment.
Results: 151 (22.7%) patients with a mean age of 55 years old were included with first epileptic seizure discharged from 18 HED with follow-up data. Preventive treatment was considered adequate in 128 (84.8%) patients. 41 (27.2%) patients presented some adverse outcome 30 days after discharge. After the logistic regression, the appropriate preventive treatment to the discharge of the HED exerts a protective effect on the variable «some adverse outcome to 30 days».
Conclusions: In the ACESUR registry, preventive treatment was adequate for most patients and its effect was independent protective at 30 days. Therefore, adequate preventive treatment could improve the short-term results of adult patients discharged with the first epileptic seizure of the HED.
Databáze: MEDLINE