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Factors affecting mortality of refractory status epilepticus
Author(s) -
Tatlidil Isil,
Ture Hatice S.,
Akhan Galip
Publication year - 2020
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.13173
Subject(s) - medicine , status epilepticus , coma (optics) , intubation , intensive care unit , population , mortality rate , glasgow coma scale , comorbidity , subgroup analysis , multivariate analysis , retrospective cohort study , anesthesia , pediatrics , epilepsy , confidence interval , psychiatry , physics , environmental health , optics
Objective The aim of this study was to determine the factors affecting the mortality of refractory status epilepticus (RSE) in comparison with non‐refractory status epilepticus (non‐RSE). Material‐Method Included in this retrospective study were 109 status epilepticus cases who were hospitalized in the neurological intensive care unit Katip Celebi University. Fifty‐two were RSE and 57 were non‐RSE. All clinical data were gathered from the hospital archives. Factors which may cause mortality were categorized for statistical analysis. Results While elderly age, continuous clinical seizure activity, absence of former seizure, infection, prolonged stay of ICU, anesthesia, and cardiac comorbidity were significantly related to mortality in the RSE subgroup, potentially fatal accompanying diseases were significantly related to mortality in the non‐RSE subgroup. No significant relationship was found between mortality and refractoriness. Multivariate analysis revealed that a Glasgow Coma Score (GCS) at presentation of 8 or lower was the independent predictor of mortality both in the general SE population ( P = .017) and in the RSE subgroup ( P = .007). Intubation ( P = .011) and hypotension ( P = .011) were the other independent predictors of mortality in the general SE population. No independent predictor of mortality was detected in the non‐RSE subgroup. Discussion/Conclusion Intubation, hypotension, and a low GCS at presentation could be the main factors which could alert clinicians of an increased risk of mortality in SE patients. Although non‐RSE and RSE had similar rates of mortality in the ICU, the mortality‐related factors of SE vary in the RSE and the non‐RSE subgroups.