Predictors of long-term mortality in status epilepticus

There were several studies that have reported on the long-term mortality rate of status epilepticus (SE). However, these studies were conducted mainly in Western countries using small study populations. This study aimed to evaluate predictors for long-term mortality in SE using the Thai national healthcare database.

This study was conducted using the Thai national Universal Health Coverage (UC) database. The eligibility criteria for this study were that all patients were diagnosed with SE and had been admitted to any hospital between 2005 and 2015. Mortality was defined at discharge and at one, three, five, and 10 years. All eligible patients were categorized as either having survived or having died. The mortality rates were calculated at one, three, five, and 10 years. Factors associated with mortality were analyzed using backward multivariate Cox proportional hazard regression analysis. Kaplan-Meier was performed to estimate the survival rate.

During the study period, there were 21,732 patients with SE admitted who met the study criteria. The total observation time was 85,821.28 person-years. Of the patients enrolled, 3642 (or 4.24 per 100 person-years [95% confidence interval (CI): 4.11-4.38]) died. Factors positively associated with mortality in patients with SE were central nervous system (CNS) infection, cancer, heart diseases, chronic renal failure, septicemia, pneumonia, respiratory failure, acute renal failure, and shock. Heart diseases had the highest adjusted hazard ratio at 2.69 (95% CI: 2.47-2.93). Two factors were negatively related with SE mortality: hypertension and urinary tract infection.

Long-term mortality in patients with SE had both positive and negative predictors in the national database.