Authors :
Abdullah Alqahtani, MD - KFSHRC; Fadi AlHarbi - King Faisal Specialist Hospital and Research Centre; Suad ALYamani, MD - Consultant, Pediatric Neurology & Epileptologist, Neurosciences, King Faisal Specialist Hospital & Research Centre; Hesham ALDhalaan - King Faisal Specialist Hospital and Research Centre; Sameena Khan - King Faisal Specialist Hospital and Research Centre; Tariq Abalkhail - King Faisal Specialist Hospital and Research Centre; Salah Baz - King Faisal Specialist Hospital and Research Centre
Rationale: Since there is limited data available of using rescue medication (RM) in Middle East region, our aim of this study is to gain further understanding regarding the use of RM in pediatric patients diagnosed with status epilepticus (SE) at KFSHRC in Riyadh, Saudi Arabia. Also, to determine the characteristics of SE in our group of patients and to identify potential areas for intervention to reduce the complications of SE.
Methods: Out of the 281 potentially eligible patients, 150 patients met the criteria. This is a cross sectional retrospective study conducted at KFSHRC in Riyadh from 2008-2020. In case of missing or incomplete data we tried prospectively corroborated data with families and if data still missing, we exclude them from the study.
Inclusion criteria:
- All Pediatric Patients diagnosed with status epilepticus at KFSHRC in Riyadh within a period from Jan 2008 – 2020.
- Age from (1 day -14 years).
- Focal or generalized convulsive status epileptic at onset.
Exclusion criteria:
- Non convulsive status epilepticus.
- Demographic data were incomplete or missing records regarding rescue medication administration.
Results: Out of 150 SE pediatric patients, (60%) were boys and (40%) were girls and (68.4%) were pre-school age. SE was continues in (62.0%) and majority (81%) presented with generalized onset.
The most common etiology is genetic 25%. Furthermore, the main precipitating factors were co-infection (60%) and abrupt or withdrawal of AEDs in (10%).
Regarding outcome, 40% required ICU admission with refractory SE and mortality reported in (10%) cases. Giving sub therapeutic dose of RM was associated with prolonged length of hospital stay (p0.018).
In our population we found out that the median time to reach the ER was more than 50 minutes and to receive RM in patients who presented with SE was 8 minutes.
Although 78% of patients already have previous history of SE, only 16 patients received RM at home.
Conclusions:
- Barriers to timely management of status epilepticus may occur at any step of the care process, from preventive care and education to acute, in-hospital management.
- Our study shed light into the low usage of pre-hospital RM as well as unacceptably delay management initiation.
- With identification of such barriers, our center has taken on initiatives to improve management and time to RM administration.
Funding: Please list any funding that was received in support of this abstract.: None.