Abstracts

Status Epilepticus (SE) has a high morbidity and mortality. This study was conducted to identify common laboratory values that can be useful in predicting SE outcome. The NIH Greater Richmond Metropolitan Area Status Epilepticus Data System was used; prospectively collected data on SE cases in Richmond, Virginia. Common chemistry laboratory results were examined, including sodium, potassium, chloride, CO2, glucose, BUN and creatinine. The time the specimen was obtained, either during or after SE, was also analyzed. Cases were divided into 3 age groups: pediatric (up to age 16), adult (16-59) and elderly (60 and above). Race, gender and SE etiology were also examined, as well as SE duration, location of SE onset (in the hospital or outside of the hospital) and SE type (nonconvulsive, partial, general and other). A total of 948 cases were available for this analysis: 275 pediatric, 327 adult and 346 elderly. Utilizing multivariate logistic regression analysis, the following variables were identified as significant in predicting mortality: elevated BUN (p[lt]0.05), age (p[lt]0.0001), etiology (p[lt]0.0001), whether the specimen was obtained during or after SE (p[lt]0.006) and location of SE onset (p[lt]0.02). There were no significant differences in race, gender, SE type, SE duration, sodium, potassium, chloride, CO2, creatinine or glucose. Elevated BUN was more common in elderly cases (28%) versus adult (15%) and pediatric (5%) cases, and was seen in proportionately higher percentages in the nonCNS acute and Hypoxia/Anoxia etiology categories in all age groups. Mortality was significantly higher in cases with elevated BUN in all age groups. In pediatric cases with normal BUN, mortality was 5% versus 27% in cases with elevated BUN; for adults mortality was 12% in the normal BUN group and 36% in the elevated BUN group, and in elderly cases, mortality was 23% in the normal BUN group and 43% in the elevated BUN group. Elevated BUN values were more commonly seen when the laboratory sample was obtained during SE versus after SE. When examining location at SE onset, elevated BUN was seen in 33% of SE cases that began in the hospital versus 11% of cases that began outside of the hospital. Blood chemistry tests are routinely obtained on patients, with results being available relatively quickly. This study shows that elevated BUN levels are highly predictive of SE mortality and may be useful in making decisions regarding patient management. (Supported by NIH P50NS25630)