Predicting outcome of status epilepticus

Leitinger, Markus; Kalss, Gudrun; Rohracher, Alexandra; Pilz, Georg; Novak, Helmut F.; Höfler, Julia; Deak, Ildiko; Kuchukhidze, Giorgi; Dobesberger, Judith; Wakonig, A; Trinka, Eugen

doi:10.1016/j.yebeh.2015.04.066

Cited by 44 publications

(35 citation statements)

References 29 publications

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“…Correctly classified (accuracy) was: EMSE 78.0%, STESS-3 52.0% (p = 0.012), and STESS-4 58.0% (p = 0.054). AED: antiepileptic drug, n/a: not applicable; reporting of semiology in standard format [13].…”

Section: Resultsmentioning

confidence: 99%

Salzburg Consensus Criteria for Non-Convulsive Status Epilepticus – approach to clinical application

Leitinger

Beniczky

Rohracher

et al. 2015

Epilepsy & Behavior

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Section: Resultsmentioning

confidence: 99%

Salzburg Consensus Criteria for Non-Convulsive Status Epilepticus – approach to clinical application

Leitinger

Beniczky

Rohracher

et al. 2015

Epilepsy & Behavior

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357

298

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“…Rate of misdiagnosis of NCSE could be minimized by using the electro-clinical diagnostic criteria for NCSE. But still there are borderline EEG patterns, and sometimes there might have been an overlap between NCSE and severe encephalopathies, which might confound treatment response and outcome [20]. …”

Section: Discussionmentioning

confidence: 99%

“…The last AED administered before SE cessation was defined as the termination drug, regardless of the latency between its first administration and SE cessation. To estimate mortality risk, the epidemiology-based mortality score in SE (EMSE) (cutoff level for bad outcome 64 points) [20] was used. Outcome after SE was assessed by the Modified Rankin Scale (mRS).…”

Section: Methodsmentioning

confidence: 99%

(S)-Ketamine in Refractory and Super-Refractory Status Epilepticus: A Retrospective Study

et al. 2016

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ObjectiveThe aim was to describe the safety and efficacy of (S)-ketamine [(S)-KET] in a series of patients with refractory and super-refractory status epilepticus (RSE and SRSE) in a specialized neurological intensive care unit (NICU).MethodsWe retrospectively analyzed the data of patients with RSE and SRSE treated with (S)-KET in the NICU, Salzburg, Austria, from 2011 to 2015. Data collection included demographic features, clinical presentation, diagnosis, electroencephalogram (EEG) data, anticonvulsant treatment, timing, and duration of treatment with (S)-KET. Outcomes were seizure control and death.ResultsA total of 42 patients (14 women) with RSE and SRSE were treated with (S)-KET. The median duration of status epilepticus (SE) was 10 days [first quartile (Q1) 5.0, Q3 21.0]; the median latency from SE onset to the first administration of (S)-KET was 3 days (Q1 2.0, Q3 6.8). Prior to (S)-KET administration, patients had received a median of two (Q1 2.0, Q3 3.0) anesthetics and three (Q1 2.0, Q3 4.0) antiepileptic drugs. Forty percent of patients (17/42) received propofol: 65 % prior to (S)-KET; 35 % at the same time with (S)-KET. Seven patients received a median bolus of (S)-KET of 200 mg (Q1 200, Q3 250) followed by a continuous infusion, while 35 started with a continuous infusion (maximum rate median 2.55 mg/kg/h; Q1 2.09, Q3 3.22). In 64 % of patients (27/42), (S)-KET was the last drug before SE cessation; in five patients, it was given with propofol at the same time. Median duration of administration was 4 days (Q1 2.0, Q3 6.8). Overall (S)-KET treatment was well tolerated, adverse effects were not observed, and overall mortality was 45.2 %.ConclusionsTreatment of SRSE in adult patients with (S)-KET led to resolution of status in 64 %. No adverse events were found, indicating a favorable safety profile.

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“…The source population of STESS came from 2 tertiary referral hospitals. 17 Mortality from SE is 38% in patients 60-79 years old, which increases to 50% for patients 80 years or older. Because of its simplicity and practicality, the STESS is used widely to predict SE outcome and stratify patients.…”

Section: Introductionmentioning

confidence: 99%

Prognostic scores in status epilepticus—a critical appraisal

2018

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Currently, there are 4 published scales evaluating status epilepticus (SE) prognosis: the Status Epilepticus Severity Score (STESS), the Epidemiology-based Mortality score in Status Epilepticus (EMSE), the modified STESS (mSTESS), and the Encephalitis Nonconvulsive Status Epilepticus Diazepam Resistence Imaging Tracheal Intubation (END-IT) score. The first prognostic score published for SE, the STESS, is a simple and practical scale that evaluates patient prognosis upon admission and is used widely to predict the outcome and stratify patients. Another scale, which was developed based on large epidemiologic studies, the EMSE, is more easily adapted to different regions around the world when assessing individual risk and stratifying patients in interventional studies. The mSTESS was created by adding the modified Rankin Scale (mRS) to the STESS, which decreases the ceiling effect and increases the mortality prediction capabilities of the STESS. The END-IT is the only prognostic scale assessing functional outcome and is comprehensively simple and satisfyingly accurate. Evaluating the limitations of each of these scales aids in the exploration and advancement of SE prognostic scales, thereby facilitating better clinical interventions and scientific research.

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Predicting outcome of status epilepticus

Cited by 44 publications

References 29 publications

Salzburg Consensus Criteria for Non-Convulsive Status Epilepticus – approach to clinical application

Salzburg Consensus Criteria for Non-Convulsive Status Epilepticus – approach to clinical application

(S)-Ketamine in Refractory and Super-Refractory Status Epilepticus: A Retrospective Study

Prognostic scores in status epilepticus—a critical appraisal

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