Epidemiology of Status Epilepticus at a Tertiary Medical Center
Abstract number :
1046
Submission category :
16. Epidemiology
Year :
2020
Submission ID :
2423379
Source :
www.aesnet.org
Presentation date :
12/7/2020 1:26:24 PM
Published date :
Nov 21, 2020, 02:24 AM
Authors :
Carolina Cuello-Oderiz, State University of New York Upstate Medical Center; You Wang - State University of New York Medical School; Shahram Izadyar - State University of New York Upstate Medical Center;;
Rationale:
Understanding the epidemiology of Status Epilepticus (SE) is of prime importance in planning preparedness for successful management for this condition. Our primary goal was studying the epidemiology of SE, including age groups, causes and prognosis, at a tertiary medical center with a Comprehensive Epilepsy Program.
Method:
We defined SE as a seizure longer than 5 minutes. We reviewed the medical record of patients 18 years of age or older admitted to our hospital from November 2018 to March 2019 and with primary or secondary discharge diagnosis of SE. As a measure of outcome, we defined good outcome as discharge to home, intermediate as discharge to rehabilitation and poor as death. We performed an ANOVA test to determine if there was a difference in the group population, response to treatment received and the prognosis of the patient.
Results:
During this time period of our study, 66 patients were identified with SE. 16 patients were excluded because the diagnosis did not meet our inclusion criteria. Age average was 59 (SD 19.6) and 25 were female. 64% of the patients had predominantly motor or convulsive SE. 24 patients (49%) had prior history of epilepsy among whom 83% had low AEDs levels upon admission when that information was available. The average number of home AEDs was 1.7. The leading causes were: cryptogenic (18%), anoxic brain injury (18%), tumor (16%) and traumatic brain injury (16%). 85% of video-EEGs showed slowing, 46% periodic discharges and 32% seizures. 44 patients received levetiracetam as first AEDs. When anesthetics drugs were needed, midazolam was used in 20 patients, propofol in 16, ketamine in 5 and pentobarbital in 1. There was a tendency that patients with better outcome had a higher weight-dose load of levetiracetam but not statistically significant. More days on video-EEG correlated with better outcome (p< 0.05). Older age was associated with poorer outcome (p< 0.1). Average days of total hospital and ICU stay were 13.2 and 9, respectively.
Conclusion:
In our center, most patients admitted with SE were elderly or had a history of epilepsy. Non-compliance with home AEDs was seen in almost half of patients with prior history of epilepsy. Only a third of video-EEGs showed seizures. Longer video-EEG was associated with better outcome while older age with poor outcome.
Funding:
:None
Epidemiology