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Use of newer antiepileptic drugs and prognosis in adults with status epilepticus: Comparison between 2009 and 2017
Author(s) -
Fatuzzo Daniela,
Novy Jan,
Rossetti Andrea O.
Publication year - 2018
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.14434
Subject(s) - medicine , status epilepticus , odds ratio , confidence interval , pediatrics , epilepsy , psychiatry
Summary It is unclear whether the outcome of status epilepticus ( SE ), a neurological emergency associated with high mortality and morbidity, has changed over the past decade. We investigated the difference in prognosis (mortality, functional status at discharge) after adult SE episodes in a large registry between 2 time points (the years 2009 and 2017), exploring factors potentially associated with outcome, with particular attention to use of newer antiepileptic drugs ( AED s). Newer AED s were more often prescribed in SE episodes in 2017 (80.2% vs 38.5%, P  < .001); this independently correlated with year of observation, SE refractoriness, nonconvulsive SE forms, and number of AED s. We observed a higher proportion of deterioration from baseline conditions in 2017 (67.7% vs 42.3%, P  < .001), which was independently associated with, among other variables, use of newer AED s (odds ratio = 2.91, 95% confidence interval = 1.13‐7.48), whereas mortality seemed more stable over time (16.1% vs 6.3%, P  = .08) without any relationship with newer AED s. These observations suggest that newer AED s might affect functional status but not mortality. Further investigations are necessary to improve therapeutic strategies, which currently rely on weak evidence.

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