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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
Summary
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.
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