Abstracts

Rationale:
Status epilepticus (SE) is life-threatening condition. We intended to identify in-hospital mortality rate in patients admitted for SE and we hypothesized that the patient demographics, medical comorbidities and seizure types are associated with in-patient mortality.
Method:
Using the Nationwide Inpatient Sample (NIS) database, we examined medical comorbidities and characteristics in patients admitted with diagnosis of SE from October 2015 to December 2016 in the United States. ICD-10 codes were used to identify patients who were admitted for SE. Univariate and multivariate regression analyses were performed to identify independent risk factors for in-hospital mortality.
Results:
A total of 78,194 patients were identified. The mean age was 41 years (+/-27) with similar sex distribution (Female; 50.55% vs. Male: 49.45%). Sixty percent were Caucasian, and 63% of patients were admitted in teaching hospitals. Mean length of hospital stay was 5.5 days. The in-hospital mortality in the cohort with an admission diagnosis of SE was 2.0 %. Multivariate regression analysis showed that among medical comorbidities the only independent risk factor for in-hospital mortality was liver failure (adjusted odds ration [AOR], 2.14). Demographic predictors of mortality included: age > 65 years (AOR, 3.07), Native American ethnicity (AOR, 2.34) and male sex (AOR, 1.33). Additional predictors of mortality included non-compliance with medication (AOR, 1.53) and teaching status of hospital (AOR, 1.47). Other ethnicities (African- American, Hispanic, Asian), hypertension, diabetes mellitus, chronic lung disease, congestive heart failure, chronic kidney disease, obesity, chronic anemia, smoking, alcohol abuse, history of brain tumor, history of CVA, seizure type or CNS infection did not carry higher risk for mortality.
Conclusion:
The rate of mortality in SE is not insignificant (2.0 %). This study demonstrated that age >65 years, Native American ethnicity, liver disease, non-compliance with medication and teaching hospital were significant predictors for mortality in SE. Knowledge of these risk factors may aid neurologists identify high risk patients, and show the importance of reinforcing medication compliance in at high risk patients, which could contribute to a reduction of in-hospital mortality. The higher mortality rate in teaching hospitals is likely related to transferring more complex patients to the larger tertiary teaching hospitals; however, future prospective studies will need to investigate the explanations for this fact.  
Funding:
:None