Evaluation of outcomes related to dosage inaccuracies in the treatment of status epilepticus
Abstract number :
940
Submission category :
4. Clinical Epilepsy / 4C. Clinical Treatments
Year :
2020
Submission ID :
2423273
Source :
www.aesnet.org
Presentation date :
12/7/2020 1:26:24 PM
Published date :
Nov 21, 2020, 02:24 AM
Authors :
Pamela O'Dea, University of Virginia; Camilo Gutierrez - University of Maryland Medical Center;
Rationale:
SE that is not treated appropriately at onset becomes more difficult to treat and may progress to refractory or super-refractory SE, leading to worse outcomes including neurologic deficits, poor functional status, or death. Treating SE early and with the appropriate dose of medication can prevent or reduce morbidity and mortality.
Method:
Retrospective chart review was performed on 250 patients admitted to our institution between October 2015 and October 2017. Charts were selected if they contained an ICD code for SE. Patients were included if they were treated for new-onset status epilepticus. Patients were excluded if they were under age 18 or if they were transferred from an outside institution with a known diagnosis of status epilepticus. In patients experiencing multiple episodes of status epilepticus, each episode was considered separately. First and second line medication choice and dose were compared to the American Epilepsy Society 2016 guidelines. Mortality and length of stay were compared to adherence to guidelines for first and second line medications.
Results:
A total of 109 episodes of status epilepticus were collected. Analysis of variance was used to compare length of hospital stay between those who had appropriate 1st (2nd) dose administered and who had not, there is no evidence of dose being appropriate and length of stay being associated, p-value = 0.93 (p-value = 0.47). The general linear model approach was used to estimate possible association between the length of stay and the following independent variables, age, gender, weight, race, seizures, epilepsy, and lesion. Only 89 alive subjects were included in the model and only presence of seizures was predictive of the length of stay (p-value = 0.001). Patients with seizures had median stay of 8 days vs 11.5 for cases without seizures.
Conclusion:
The results of this study suggest that dose adherence to guidelines of medications is not the most important factor when considering outcomes from SE. Other studies have suggested that age, etiology of seizures, and timing of medication are more important.
Funding:
:None
Clinical Epilepsy