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Time to Treatment in Pediatric Convulsive Refractory Status Epilepticus: The Weekend Effect

Cristina Barcia Aguilar1, Marta Amengual-Gual2, Iván Sánchez Fernández3

  • 1Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Child Neurology, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, Spain.

Pediatric Neurology
|May 22, 2021
PubMed

Insights

Treatment time for pediatric refractory status epilepticus is shorter on weekends/holidays, especially for in-hospital cases. This finding may help improve emergency medication timing.

Area of Science:

  • Pediatric Neurology
  • Emergency Medicine
  • Clinical Pharmacology

Background:

  • Pediatric refractory status epilepticus (RSE) is a medical emergency.
  • Treatment delays in pediatric RSE are a concern.
  • Weekends and holidays may impact treatment initiation times.

Purpose of the Study:

  • To investigate the effect of weekends and holidays on treatment initiation for pediatric refractory status epilepticus.
  • To analyze time to first benzodiazepine (BZD) and non-benzodiazepine anti-seizure medication (ASM) in pediatric RSE.

Main Methods:

  • Retrospective analysis of prospectively collected observational data.
  • Inclusion of 329 pediatric patients diagnosed with refractory status epilepticus.
  • Comparison of treatment times between weekdays and weekends/holidays.

Main Results:

  • Time to first non-benzodiazepine ASM was significantly shorter on weekends/holidays (59 minutes) compared to weekdays (68 minutes) (P=0.006).
  • This difference was primarily observed in patients with in-hospital onset RSE.
  • For in-hospital onset RSE, time to first non-BZD ASM was 28 minutes on weekends/holidays versus 55.5 minutes on weekdays (P=0.003).

Conclusions:

  • Treatment with non-benzodiazepine ASMs for pediatric RSE is initiated faster on weekends/holidays, particularly for in-hospital cases.
  • Understanding the reasons for this disparity can inform strategies to optimize medication timing in pediatric RSE.
  • Further research is needed to identify factors contributing to these temporal treatment differences.
Abstract

Keywords:
Clinical neurologyEpilepsyOutcome researchPediatricStatus epilepticus

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