NEW ONSET STATUS EPILEPTICUS IN HOSPITALIZED PATIENTS - A DISTINCT SUBSET OF STATUS PATIENTS
Abstract number :
3.109
Submission category :
Year :
2002
Submission ID :
1507
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Elizabeth J. Waterhouse, Linda K. Garnett, Lawrence D. Morton, Eleanor Campbell, Robert J. DeLorenzo, Alan R. Towne. Neurology, Virginia Commonwealth University School of Medicine, Richmond, VA; Biostatistics, Virginia Commonwealth University, Richmond, V
RATIONALE: Status epilepticus (SE) commonly occurs in patients with a history of epilepsy. However, SE that occurs de novo, as a complication of acute medical and neurologic conditions, represents a distinct clinical scenario that may have different characteristics and prognosis. A recent retrospective study found a 61% mortality in this subset of patients.1
: At the end of this activity the participants should be able to discuss the characteristics and prognosis of new onset of SE in hospitalized patients.
METHODS: Seven hundred seventy-five prospectively identified SE cases in the NIH Greater Richmond Metropolitan Area SE database were included, and were divided into four patient populations: (1) no prior history of seizures, and new onset of SE while hospitalized; (2) no history of seizures and new onset of SE outside the hospital; (3) history of seizures but not SE; and (4) history of SE and seizures. Parameters examined were age, mortality, race, etiology, SE type, and duration.
RESULTS: There were 158 patients in group 1, 250 in group 2, 190 in group 3, and 175 in group 4. The groups did not significantly differ with respect to gender. Inpatient de novo SE was significantly more likely to occur in the elderly and in Caucasians. Group I patients were significantly more likely than other groups to have SE etiology of hypoxic/anoxic injury or acute CNS process. SE in Group 1 patients, compared to other groups, was significantly more likely to be prolonged, to be nonconvulsive, and to result in death. The mortality rates were: Group 1--53%, Group 2--22%, Group 3--17%, and Group 4--6%.
CONCLUSIONS: Hospitalized patients with new onset SE are a distinct subset of SE patients with characteristics associated with a significantly worse prognosis. These findings emphasize the need for clinical vigilance in this at-risk subset of hospitalized patients, and have implications for therapeutic strategies.
1 Delanty N, French JA, Labar DR, Pedley TA, Rowan AJ, Status epilepticus arising de novo in hospitalized patients: an analysis of 41 patients. Seizure 2001: 10: 116-119.
[Supported by: NIH PO1 NS25630]