The Prevalence and Impact of Status Epilepticus Secondary to Intracerebral Hemorrhage: Results from the US Nationwide Inpatient Sample

Mehta, Amol; Zusman, Benjamin; Shutter, Lori; Choxi, Ravi; Yassin, Ahmed; Antony, Arun

doi:10.1007/s12028-017-0489-1

Cited by 7 publications

(6 citation statements)

References 32 publications

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“…There is uncertainty about the prognostic significance of abnormal electrographic patterns in the setting of ICH. 325,326 The clinical context should therefore be considered in the decision-making process. The recommendation is to initiate antiepileptic medication in the context of an electrographic seizure that is clinically suspected to be contributing to the impaired consciousness in order to improve morbidity (defined as LOS >14 days or discharge to somewhere other than home or a rehabilitation facility).…”

Section: Synopsismentioning

confidence: 99%

See 1 more Smart Citation

2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association

Greenberg¹,

Ziai²,

Cordonnier³

et al. 2022

Stroke

692

472

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other entities (RWI) can be found at https://professional. heart.org/-/media/phd-files/guidelines-and-statements/ policies-devolopment/aha-asa-disclosure-rwi-policy-5118. pdf?la=en.Beginning in 2017, numerous modifications to AHA/ ASA guidelines have been implemented to make guidelines shorter and enhance user-friendliness. Guidelines are written and presented in a modular knowledge chunk format; each chunk includes a table of recommendations, a brief synopsis, recommendation-specific supportive text, and, when appropriate, flow diagrams or additional tables. Hyperlinked references are provided to facilitate quick access and review. Other modifications to the guidelines include the addition of Knowledge Gaps and Future Research segments in some sections and a web guideline supplement (Online Data Supplement) for useful but noncritical tables and figures.

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Section: Synopsismentioning

confidence: 99%

“…One of the primary challenges in this area is that the studies differ on the definition of seizure and method of detection. 325,329,330 Another consideration is that seizures may be a marker of ICH rather than specifically affecting outcomes. 327 Recommendation-Specific Supportive Text 1.…”

Section: Synopsismentioning

confidence: 99%

2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association

Greenberg¹,

Ziai²,

Cordonnier³

et al. 2022

Stroke

692

472

View full text Add to dashboard Cite

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“…Cerebral injury also accounts for the 62% mortality rate we found in patients exhibiting any type of seizure postoperatively and replicates findings by other researchers who showed that poor outcomes were primarily seen in seizure patients who concomitantly presented with new brain injury [ 3 , 8 , 18 ]. Even if there is no visible structural damage detected in the CCT images, subtle neuronal insults may occur in the context of CPB [ 21 , 22 , 23 ], which cause encephalopathy and might also induce epileptic activity in susceptible patients [ 24 , 25 ]. Especially when cerebral damage has already manifested itself, it becomes even more important to detect NCSE early, so that it can be treated quickly and vigorously in order to prevent additional neuronal injuries, thereby reducing severe disability [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Nonconvulsive Status Epilepticus after Cardiac Surgery on Outcome

Skhirtladze-Dworschak

Felli

Aull‐Watschinger

et al. 2022

JCM

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Neurological complications after heart surgery are associated with tremendous morbidity and mortality. Nonconvulsive status epilepticus (NCSE), which can only be verified by EEG, may cause secondary brain damage. Its frequency and its impact on outcomes after cardiac surgery is still unclear. We collected the neurological files and clinical data of all our patients after heart surgery who, in the course of their ICU stay, had been seen by a neurologist who ordered an EEG. Within 18 months, 1457 patients had cardiac surgery on cardiopulmonary bypass. EEG was requested for 89 patients. Seizures were detected in 39 patients and NCSE was detected in 11 patients. Open heart surgery was performed in all 11 NSCE patients, of whom eight showed concomitant brain insults. None had a history of epilepsy. Despite the inhibition of seizure activity with antiseizure medication, clinical improvement was only noted in seven NCSE patients, three of whom were in cerebral performance category 2 and four in category 3 at hospital discharge. The four patients without neurological benefit subsequently died in the ICU. The occurrence of NCSE after open cardiac surgery is significant and frequently associated with brain injury. It seems prudent to perform EEG studies early to interrupt seizure activity and mitigate secondary cerebral injury.

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“…It has also been reported that status epilepticus was an independent risk factor for fatality of the patients with spontaneous cerebral hemorrhage[ 29 ], especially, in the patients with refractory and nonconvulsive epilepsy. These patients often require intubation and mechanical ventilation because these patients might stop breathing and heart-beating.…”

Section: Discussionmentioning

confidence: 99%

Risk factors of mortality and severe disability in the patients with cerebrovascular diseases treated with perioperative mechanical ventilation

Zhang¹,

Chen²,

Wang³

et al. 2022

WJCC

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BACKGROUND The prognosis of cerebrovascular diseases treated with mechanical ventilation during perioperative has not been clearly reported. AIM To analyze mortality and functional disability and to determine predictors of unfavorable outcome in the patients with cerebrovascular diseases treated with mechanical ventilation. METHODS A retrospective follow-up study of 111 cerebrovascular disease patients who underwent mechanical ventilation during the perioperative period in the First Hospital of Jilin University from June 2016 to June 2019 was performed. Main measurements were mortality and functional outcome in-hospital and after 3-month follow-up. According to the modified rankin scale (mRS), the functional outcome was divided into three groups: Good recovery (mRS ≤ 3), severe disability (mRS = 4 or 5) and death (mRS = 6). Univariate analysis was used to compare the differences between three functional outcomes. Multivariate logistic regression analysis was used to for risk factors of mortality and severe disability. RESULTS The average age of 111 patients was 56.46 ± 12.53 years, 59 (53.15%) were males. The mortality of in-hospital and 3-month follow-up were 36.9% and 45.0%, respectively. Of 71 discharged patients, 46.47% were seriously disabled and 12.67% died after three months follow-up. Univariate analysis showed that preoperative glasgow coma scale, operation start time and ventilation reasons had statistically significant differences in different functional outcomes. Multiple logistic regression analysis showed that the cause of ventilation was related to the death and poor prognosis of patients with cerebrovascular diseases. Compared with brainstem compression, the risk of death or severe disability of pulmonary disease, status epilepticus, impaired respiratory center function, and shock were 0.096 (95%CI: 0.028-0.328), 0.026 (95%CI: 0.004-0.163), 0.095 (95%CI: 0.013-0.709), 0.095 (95%CI: 0.020-0.444), respectively. CONCLUSION The survival rate and prognostic outcomes of patients with cerebrovascular diseases treated with mechanical ventilation during the perioperative period were poor. The reason for mechanical ventilation was a statistically significant predictor for mortality and severe disability.

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The Prevalence and Impact of Status Epilepticus Secondary to Intracerebral Hemorrhage: Results from the US Nationwide Inpatient Sample

Abstract: SE is a significant, likely underdiagnosed, predictor of morbidity and mortality after ICH. Future studies are necessary to better identify which patients are at highest risk of SE to guide resource utilization.

Cited by 7 publications

References 32 publications

2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association

2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association

The Impact of Nonconvulsive Status Epilepticus after Cardiac Surgery on Outcome

Risk factors of mortality and severe disability in the patients with cerebrovascular diseases treated with perioperative mechanical ventilation

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