Factors affecting mortality of refractory status epilepticus

Area of Science:

• Neurology
• Critical Care Medicine
• Intensive Care

Background:

• Status epilepticus (SE) is a neurological emergency with varying mortality rates.
• Refractory status epilepticus (RSE) presents unique challenges in management and outcomes.
• Understanding mortality predictors is crucial for improving patient care in SE.

Purpose of the Study:

• To identify factors associated with mortality in refractory status epilepticus (RSE) compared to non-refractory status epilepticus (non-RSE).
• To determine independent predictors of mortality in SE patients.

Main Methods:

• Retrospective analysis of 109 status epilepticus cases from a neurological intensive care unit.
• Categorization of clinical data to identify mortality-related factors.
• Statistical analysis including multivariate analysis to detect independent predictors.

Main Results:

• Elderly age, continuous seizures, new-onset seizures, infection, prolonged ICU stay, anesthesia, and cardiac comorbidity were linked to mortality in RSE.
• Potentially fatal comorbidities were associated with mortality in non-RSE.
• Low Glasgow Coma Score (GCS ≤ 8), intubation, and hypotension were independent predictors of mortality in the overall SE population and RSE subgroup.

Conclusions:

• Low GCS, intubation, and hypotension are key indicators of increased mortality risk in SE patients.
• While overall mortality rates may be similar, the specific factors contributing to death differ between RSE and non-RSE.
• Clinicians should be vigilant for these predictors to manage SE patients effectively.