Abstracts

Rationale: To evaluate the incidence of periodic discharges (PDs) and their clinical implications. Methods: A single center, retrospective study was performed from January 1, 1999, through December 31, 2015, of consecutive adult patients from either hospitalization or outpatient clinics who underwent EEG recording. Demographic data, including age, gender, main etiologies, EEG findings, associated seizure events, antiepileptic drugs (AEDs) use, and outcome at discharge were analyzed. Data was evaluated for clinical predictors of in-hospital mortality and non-dependent activity of daily living. Results: A total of 420 patients were included. The mean age of patients was 66 years, and 205 (49%) were male. The main etiology included systemic infection (24%), anoxia (15%), and ischemic stroke (12%). Acute seizures were identified in 283 patients (67%), included 30 patients with status epilepticus. A total of 154 patients (37%) did not survive to hospital discharge. In multivariable analysis, older age > 65 years (P < 0.001; OR = 2.49, 95% CI = 1.56?"3.99), systemic infection (P = 0.001; OR = 2.49, 95% CI = 1.48?"4.22), anoxic encephalopathy (P = 0.003; OR = 2.63, 95% CI = 1.40?"4.92), and presence of generalized periodic discharges (P = 0.025; OR = 1.83, 95% CI = 1.08?"3.11) were independent predictors of in-hospital mortality. Conversely, the use of AEDs was negatively associated with fatal outcome (P = 0.019; OR = 0.52, 95% CI = 0.30?"0.90). Conclusions: In patients with EEG recording during a 17-year follow up period, PDs occurred in 420 patients, and was associated with high comorbidities and poor prognosis. Several independent factors relating to in-hospital mortality were recognized, while the use of AEDs could reversely be associated with less mortality. Funding: The authors would like to thank Chang Gung Memorial Hospital, Taiwan (CMRPG3E1821) for financially supporting this research.