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Long‐term prognosis related to deep sedation in refractory status Epilepticus
Author(s) -
Caronna Edoardo,
Vilaseca Andreu,
Maria Gràcia Gozalo Rosa,
Sanchez Corral Anna,
Santafé Manel,
Sueiras María,
Guzmán Lorena,
Quintana Manuel,
ToledoArgany Manuel,
Santamarina Estevo
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.13302
Subject(s) - sedation , status epilepticus , medicine , coma (optics) , refractory (planetary science) , anesthesia , glasgow coma scale , intensive care unit , epilepsy , psychiatry , physics , astrobiology , optics
Objective To evaluate long‐term prognosis in patients with refractory status epilepticus according to the level of sedation reached during drug‐induced coma. Materials and Methods Longitudinal study of patients with status epilepticus who received anesthetics to induce therapeutic coma. Demographic data, clinical, and electroencephalographic characteristics were collected, as well as variables related to sedation. We considered as deep sedation the EEG burst‐suppression patterns (suppression ratio > 50%). A GOSE (Glasgow Outcome Scale Extended) score of 7 or 8 was considered as good prognosis. A comparative study was carried out to identify predictors of good or poor prognosis at discharge, at 1 and 2 years of follow‐up. Results We included 61 patients: 63.9% were men; mean age 53.5 ± 16.8 years (range 16‐86 years), 39.3% reached deep sedation; 62.3% had > 48 h induced coma. The median hospital stay was 21 days, while 10 days in the intensive care unit (ICU). In the multiple regression analysis, an ICU length of stay ≥ 7 days was associated with poor prognosis at discharge and at long‐term ( P < .05), while deep sedation was associated only with poor long‐term prognosis (1 and 2 years, P < .05). The Kaplan‐Meier curve showed higher survival in the group that did not undergo deep sedation ( P < .05). Conclusions In refractory status epilepticus, deep sedation is associated with poor prognosis at long‐term.