Systemic inflammatory response syndrome in the course of status epilepticus: 7-year, two-center observational study

This study was aimed at identifying patients with systemic inflammatory response syndrome (SIRS) and determining whether the presence of SIRS on admission was associated with drug resistance and poor outcome in status epilepticus (SE) patients.

We conducted a prospective review of patients consecutively admitted to two territory centers over a 7-year period. SIRS was considered present if the necessary criteria persisted for 12h. Other potential outcome predictors in a cohort of patients with SE were also collected. The primary outcome was defined as mortality during 30 days of observation, and the secondary outcome was defined as refractory SE. Logistic regression was used to determine independent predictors.

Of 127 subjects, 85 patients met the inclusion criteria. In the entire population, 43% developed SIRS at SE onset and, among them, 16% had SIRS attributed to SE alone. Subjects with refractory SE accounted for 39%, and the mortality rate for the entire population was 35%. SIRS was independently associated with drug resistance (OR 3.93, 95% CI: 1.57-9.9) and death (OR 6.76, 95% CI: 1.33-34.32).

We observed that approximately half of the patients with SE developed SIRS, and that SIRS is the independent risk factor for drug resistance and death. We also observed that SIRS was a secondary event for SE itself.