Etiology, Risk Factors, Mortality and Morbidity of Status Epilepticus in Children: A Retrospective Cross-Sectional Study in Tehran, Iran

Abstract

Background: Risk factors identification associated with status epilepticus is valuable in order to prevent morbidity and mortality in children. This study aimed to consider the etiology, risk factors, morbidity and mortality in children with status epilepticus. Methods: This retrospective cross-sectional study was performed on 119 patients aged from one month old to 15 years old. Patients’ data were recorded, including basic demographic, etiology and clinical information. The different risk factors correlated to morbidity and mortality were evaluated in this study. Results: The most common etiologies were acute symptomatic and febrile status epilepticus by 32.8% and 22.7%, respectively. Abnormal brain imaging results were reported far more frequently in patients with a history of neurodevelopmental delay and previous status epilepticus (p<0.001). The overall morbidity and mortality rates were 18.9% and 10.9%, respectively; while these rates in patients with delayed development (45.16% and 18.42%, respectively) were significantly higher than patients with normal development (8% and 7.4%, respectively). The morbidity rates in patients with previous seizures and previous status epilepticus were remarkably higher than those without previous history of seizure (26.41% vs 11.32%; p=0.047) and without previous status epilepticus (36.36% versus 14.28%; p=0.018). The length of hospital stay in patients with mortality was considerably longer than patients without mortality (12.30 ± 16.1 days vs 7.29 ± 6.24 days; p=0.033). The mortality rate in patients with normal Lumbar Puncture result was notably lower than those with abnormal LP result (2.9% vs 50%). The morbidity rate in patients with abnormal brain imaging results (p<0.001) was significantly greater than those in patients with normal results. The mortality rate was relatively higher in patients with abnormal imaging results compared to those normal results. Etiology was an important predictor of mortality and morbidity rates; acute symptomatic (32.8%), febrile status epilepticus (22.7%) and remote symptomatic (16.8%) etiologies were the most common underlying causes of S.E. While in children less than 3 years old, the acute symptomatic etiology and febrile status epilepticus etiologies were estimated as the most common, in most patients older than 3 years old the most common etiology of status epilepticus was unknown. Congenital brain defects etiology had the highest mortality (36.36%) and morbidity (42.85%) rate. The lowest morbidity (3.84%) and mortality (0%) rates were for patients with febrile status epilepticus etiology. Conclusion: Age, developmental delay, history of previous status epilepticus, the length of hospital stay, abnormal brain imaging results and the underlying etiology of status epilepticus were associated with increased morbidity and mortality among children with status epilepticus.

Risk factors of delayed developmental milestones among infants attending RCH clinics in Dodoma region. A cross-sectional studydoma region

“…The similar study form India observed that socioeconomic status, parenting, social environment and interactions as a the strongest risks for poor cognitive performance in children (Zhang et al, 2020). Therefore, therefore is important to consider the aetiology and risk factors in the evaluation of morbidity in these children (Vafaee-Shahi et al, 2020). These could show the importance of these networks surrounding the children, safeguarding the wellbeing and the optimal child growth.…”

Status Epilepticus in Children

“…In a recent 2020 retrospective cross-sectional study of 119 patient aged from one month to 15 years [39], the most common aetiologies were acute symptomatic and febrile SE occurred in 32.8% and 22.7% respectively and remote symptomatic in 16.8% aetiologies were the most common underlying causes of S.E. While in children less than 3 years old, the acute symptomatic aetiology and febrile status SE aetiologies were estimated as the most common, in most patients older than 3 years old the most common aetiology of SE was unknown.…”

“…While in children less than 3 years old, the acute symptomatic aetiology and febrile status SE aetiologies were estimated as the most common, in most patients older than 3 years old the most common aetiology of SE was unknown. Furthermore, aetiology appears an important predictor of mortality and morbidity [39], (Table 2).…”