Prognosis of status epilepticus in elderly patients

Purpose To evaluate the clinical features and prognosis of status epilepticus ( SE ) in patients above 70 years old. Methods Retrospective analysis of all patients ≥70 years old with SE registered prospectively during 4 years. Follow‐up after discharge was performed. Results Ninety patients were evaluated. Acute symptomatic etiology was the most prevalent. The mean number of antiepileptic drugs ( AED s) used was 2.7 ± 1.2, and 21% of the patients required sedation. A poor outcome was considered when death (31.1%) or developing of new neurological impairment at discharge (32.2%) occurred. After multivariate analysis, four variables predicted a poor outcome: acute symptomatic etiology ( OR : 6.320; 95% CI : 1.976‐20.217; P  = .002), focal motor SE type ( OR : 9.089; 95% CI : 2.482‐33.283; P  = .001), level of consciousness ( OR : 4.596; 95% CI : 1.903‐11.098; P  = .001), and SE duration >12 hours ( OR : 3.763; 95% CI : 1.130‐12.530; P  = .031). Independent predictive factors of mortality were SE duration >12 hours ( OR : 4.306; 95% CI : 1.044‐17.757; P  = .043), modified Status Epilepticus Severity Score ( mSTESS ) ( OR : 2.216; 95% CI : 1.313‐3.740; P  = .003), and development of complications ( OR : 3.334; 95% CI : 1.004‐11.070, P  = .049). Considering long‐term mortality, age ( HR 1.036; 95% CI 1.001‐1.071; P  = .044), a potentially fatal underlying cause ( HR 2.609; 95% CI 1.497‐ 4.548; P  = .001), and mSTESS score >4 ( HR 1.485; 95% CI 1.158‐1.903; P  = .002) remained as predictive factors. There was no association between sedation and the number of AED s used with outcome at discharge or long‐term mortality ( P  > .05). Conclusions: SE above 70 years old has a high morbimortality. Prognosis is not related to treatment aggressiveness.