GENERALIZED CONVULSIVE STATUS EPILEPTICUS AFTER NONTRAUMATIC SUBARACHNOID HEMORRHAGE
| Autor: | Lawrence J. Hirsch, Joshua Z. Willey, Sarah Inati, Brian T. Bateman, Stephan A. Mayer, H. Christian Schumacher, Ralph L. Sacco, Jan Claassen |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Comorbidity Logistic regression Risk Assessment Cohort Studies Age Distribution Status Epilepticus Risk Factors Humans Medicine Sex Distribution Survival rate Aged Aged 80 and over Inpatients business.industry Incidence Incidence (epidemiology) Emergency department Odds ratio Middle Aged Subarachnoid Hemorrhage medicine.disease Survival Analysis United States Confidence interval Survival Rate Brain Injuries Anesthesia Female Surgery Neurology (clinical) business Cohort study |
| Zdroj: | Neurosurgery. 61:60-65 |
| ISSN: | 0148-396X |
| Popis: | Objective To identify the frequency of and impact on outcome of generalized convulsive status epilepticus (GCSE) among patients with nontraumatic subarachnoid hemorrhage (SAH). Methods We used the Nationwide Inpatient Sample, a database of admissions to nonfederal United States hospitals between 1994 and 2002, for this study. From this database, we identified all adult patients with nontraumatic SAH who were admitted through the emergency department. Independent predictors of GCSE and mortality were identified using multivariate logistic regression. Multivariate linear regression analysis was used to determine whether GCSE was independently associated with increased cost and/or duration of hospitalization. Results Among the 29,998 patients hospitalized with nontraumatic SAH, GCSE was reported to occur in 0.2% of patients (N = 73 patients). GCSE occurred more frequently among those in the youngest tertiale (49 years old or younger; odds ratio, 3.2; 95% confidence interval, 2.0-5.1), those with renal disease (odds ratio, 4.8; 95% confidence interval, 2.6-8.8), and those who did not undergo a neurosurgical procedure involving a craniotomy (odds ratio, 2.2; 95% confidence interval, 1.3-3.8). GCSE was independently associated with higher in-hospital mortality (48% versus 33% of patients; odds ratio, 2.1; 95% confidence interval, 1.3-3.4; P = 0.002) and longer (9 versus 7 days; P = 0.016) and more expensive (US $39,677 versus US $26,686; P = 0.007) hospitalizations. Conclusion GCSE rarely complicates SAH; however, it is associated with increased patient mortality, length of hospital stay, and cost. GCSE occurs more frequently in young patients, those with a history of renal disease, and patients who do not undergo a craniotomy. |
| Databáze: | OpenAIRE |
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