Evaluation of Short-term Mortality of Status Epilepticus and Its Risk Factors

Abstract

Background and Purpose:Status epilepticus (SE) is defined as epileptic seizures of greater than five minutes or more than one seizure within a five minute period without returning to normal consciousness between them. It is a life-threatening condition particularly if treatment is delayed. Previous studies reported age, duration and etiology of SE as primary determinants of mortality.Methods:This prospective cross-sectional study performed on the patients with status epilepticus admitted in Rasoul-e-Akram hospital in Tehran. Patients followed at 30th day after SE to assess their living status.Results:Sixty-five patients, (56.9% was male) with 15 to 88 years of age entered the study. Mean duration of SE was 40 minutes and for hospital stay was 7 days. 84.6% of patients responded to treatment and 11 patients (16.9%) died within 30 days after SE. Mortality rate in patients with refractory SE was 70%. Mean interval between SE and death was 11.9 ± 11.7 days. Age, duration of SE and hospital stay, history of head trauma and neurosurgery were not predictors of mortality. Negative history for epilepsy had significantly higher mortality rate. Anoxic encephalopathy increased the mortality rate and response to treatment decreased it.Conclusions:Short-term mortality rate of SE was comparable with most of the previous reports Since our hospital has equipped emergency department, resuscitation and primary treatment of SE is usually start soon, percentage of anoxic encephalopathy is decreased and lower mortality rate is expected. We conclude that early treatment by decrease chance of anoxic encephalopathy, has significant role in outcome of SE.

Prediction of functional outcome in patients with convulsive status epilepticus: the END-IT score

“…The long-term outcome of 596 cases with refractory SE was analyzed by Ferlisi et al, the results of which indicated that 35 % of the patients had died, 13 % had a severe neurological deficit, and only 35 % recovered to baseline [ 33 ]. Recent prospective studies have also shown that refractory SE appeared to be strongly associated with poor outcomes [ 34 , 35 ]. Considering the controversy surrounding the definition of refractory SE, i.e., the number of AEDs that patients need to have failed and the duration of SE after the initiation of treatment [ 10 ], we chose several variables that reflect the features of refractory SE, including diazepam resistance, SE duration, use of three or more types of intravenous AEDs, a drug induced coma, and tracheal intubation, as candidate predictors when performing the statistical analysis.…”

Retrospective review of pediatric status epilepticus in 116 Saudi patients: predictors of outcome

“…Moghaddasi found that patients with a history of epilepsy had higher mortality rates than those without. 30 Furthermore, Kang found that a history of epilepsy was associated with neurological sequelae to a further extent than a history of acute symptomatic SE. Our study identified a history of epilepsy to be an independent predictor of outcome in SE.…”

Sparteine as an anticonvulsant drug: Evidence and possible mechanism of action

“…SE is a pathological condition in which the patient requires urgent hospitalization and emergency treatment. SE is associated with substantial morbidity and mortality [58,59]. SE has an incidence of up to 61 per 100,000 people per year and is divided into four sequential stages (early, established, refractory and super refractory) that are important in the pharmacotherapy of SE [60].…”