Early predictors of refractory status epilepticus: an international two‐center study

Sutter, Raoul; Kaplan, Peter W.; Marsch, Stephan; Hammel, Eva; Rüegg, Stephan; Ziai, Wendy

doi:10.1111/ene.12531

Cited by 43 publications

(41 citation statements)

References 32 publications

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“…The hospital mortality (10%) of patients with SRSE in our study is low compared to other studies that have reported hospital mortalities of up to 42% [4,5,13,14]. However, the hospital mortality of patients with SRSE was markedly higher than that of patients with RSE.…”

Section: Incidence and Mortalitycontrasting

confidence: 77%

“…Likewise, mortality at one year was much higher in the patients with SRSE than in the patients with RSE (36% vs. 22%). Compared to earlier studies, the long-term mortality of SRSE in our study was comparable or lower [4,5,13,14]. The exact definitions of RSE and SRSE seem to vary between different studies, making the comparisons difficult.…”

Section: Incidence and Mortalitycontrasting

confidence: 72%

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Incidence and mortality of super-refractory status epilepticus in adults

Kantanen¹,

Reinikainen²,

Parviainen³

et al. 2015

Epilepsy & Behavior

106

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Section: Incidence and Mortalitycontrasting

confidence: 77%

Section: Incidence and Mortalitycontrasting

confidence: 72%

Incidence and mortality of super-refractory status epilepticus in adults

Kantanen¹,

Reinikainen²,

Parviainen³

et al. 2015

Epilepsy & Behavior

106

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“…From previous reports we know that acute neurologic pathology is associated with both refractoriness, high mortality and poor outcome in both in SE and NCSE(Kowalski et al, 2012; Shneker and Fountain, 2003; Sutter et al, 2015). Severe consciousness impairment was also independently associated with refractoriness(Novy et al, 2010).…”

Section: Discussionmentioning

confidence: 98%

Intravenous anesthesia in treatment of nonconvulsive status epilepticus: Characteristics and outcomes

et al. 2015

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Objective To determine factors associated with continuous anesthetic drug (IVAD) use in nonconvulsive status epilepticus (NCSE). Methods Retrospective cohort study of patients who met clinical and EEG criteria of NCSE from 2009 to 2014 at a tertiary academic medical center. Patients were categorized according to IVAD use. Outcome variables were response to treatment and in-hospital death. We used descriptive analyses for baseline characteristics and outcome variable differences among patients who did and did not receive IVAD. Results Forty-three patients had a total of 45 NCSE episodes. IVAD was used in 69% of the episodes. Patients treated with IVAD were younger (53.1±14.1 vs 64.1±13.3, p=0.019). The episodes treated with IVAD occurred more frequently in patients with an acute neurologic pathology (58% vs 21%, p=0.024) and those presenting in a coma (39% vs 7%, p=0.030). NCSE resolved in 74% of the patients who received IVAD. Duration of NCSE did not differ significantly by treatment group. There were total 13 in-hospital deaths: ten in IVAD users vs three in the no-IVAD group (p > 0.05). Only one in-hospital death appeared to be a direct consequence of IVAD use. Mortality was more common among episodes that were not treated according to the published status epilepticus treatment guidelines compared to the episodes where guidelines were followed. Conclusion Our findings showed that factors such as younger age, acute neurologic pathology and coma at presentation were associated with IVAD use in patients with NCSE. These factors should be controlled in the future outcome and effectiveness studies to determine the effect of IVAD use on outcome of NCSE.

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“…found low serum albumin to have 2.3 times the odds of developing RSE. [19] Other acute phase reactant proteins have not been found significant. [20]…”

Section: Discussionmentioning

confidence: 99%

Study of refractory status epilepticus from a tertiary care center

Kohli

Pasangulapati

Yoganathan

et al. 2017

Ann Indian Acad Neurol

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Objectives:To determine the proportion of refractory status epilepticus (RSE) and super-RSE (SRSE) among patients with status epilepticus (SE) and to analyze RSE and non-RSE (NRSE) in terms of etiology and predictors for RSE.Materials and Methods:Patients were identified from discharge summaries database with keywords of SE and records of the portable electroencephalogram (EEG) machine from January 2011 to March 2016.Results:Two hundred and eighteen events were included in the study with 114 (52.3%) males, bimodal age preponderance age <5 years 30%, and second peak in age 15–65 years 52.8%, preexisting seizures were present in 34.4% (n = 75). Nearly 77.1% had NRSE (n = 168) and 22.9% had RSE (n = 50). This included 17 patients with SRSE (n = 17, 7.8% of all SE). Central nervous system (CNS) infection was a single largest etiological group in SE (69/218, 31.7%). In RSE, autoimmune encephalitis (17/50) and CNS infection (13/50) were the largest groups. De novo seizures (P = 0.007), low sensorium at admission (P = 0.001), low albumin at admission (P = 0.002), and first EEG being abnormal (P = 0.001) were risk factors on bivariate analysis. An unfavorable status epilepticus severity score (STESS) was predictive for RSE (P = 0.001). On multivariate analysis, de novo seizures (P = 0.009) and abnormal EEG at admission (P = 0.03) were predictive for RSE.Conclusions:Fifty patients had RSE (22.9%), of which 17 went on to become SRSE (7.8%). Unfavorable STESS score was predictive for RSE on bivariate analysis. On multivariate analysis, de novo seizures and abnormal initial EEG were predictors of RSE.

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Early predictors of refractory status epilepticus: an international two‐center study

Cited by 43 publications

References 32 publications

Incidence and mortality of super-refractory status epilepticus in adults

Incidence and mortality of super-refractory status epilepticus in adults

Intravenous anesthesia in treatment of nonconvulsive status epilepticus: Characteristics and outcomes

Study of refractory status epilepticus from a tertiary care center

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