Causes of Death in Status Epilepticus
Maximiliano A Hawkes1, Stephen W English2, Jay N Mandrekar3
1Department of Neurology, Division of Critical Care Neurology, Mayo Clinic, Rochester, MN.
Critical Care Medicine
|June 18, 2019
Summary
In status epilepticus, death is mainly due to underlying disease and treatment withdrawal, not specific interventions like anesthetic drugs or mechanical ventilation. The Status Epilepticus Severity Score is linked to mortality.
Area of Science:
- Neuroscience
- Critical Care Medicine
- Neurology
Background:
- Status epilepticus (SE) is a neurological emergency with significant mortality.
- Understanding factors influencing outcomes in SE is crucial for patient management.
Purpose of the Study:
- To identify causes of death in status epilepticus patients.
- To analyze the impact of seizure etiology, refractoriness, mechanical ventilation, anesthetic drugs, and medical complications on mortality and hospital length of stay.
Main Methods:
- Retrospective cohort study of 244 patients with status epilepticus.
- Analysis of electronic medical records for demographics, treatments, and outcomes.
- Logistic regression to assess associations with mortality and discharge disposition.
Main Results:
- In-hospital and 90-day mortality rates were 9.2% and 19.2%, respectively.
- Death was primarily due to underlying neurologic disease and withdrawal of life-sustaining treatment.
- Only the Status Epilepticus Severity Score was associated with mortality; anesthetic drugs, mechanical ventilation, and complications were not.
Conclusions:
- Treatment choices like anesthetic drugs and mechanical ventilation did not significantly impact mortality in SE.
- Outcomes in SE are predominantly influenced by the underlying cause and decisions regarding life support.
- Refractory seizures were associated with poorer discharge disposition.
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