Complication burden during status epilepticus and long-term mortality.

Area of Science:

• Neurology
• Critical Care Medicine
• Medical Informatics

Background:

• Status epilepticus (SE) is a neurological emergency associated with significant morbidity and mortality.
• Quantifying the burden of complications during SE treatment is crucial for outcome prediction.
• Existing tools may not comprehensively capture the spectrum of complications in SE.

Purpose of the Study:

• To validate the Complication Burden Index (CBI) for quantifying complications during SE treatment.
• To evaluate the impact of the CBI and its components on in-hospital and 6-month mortality.
• To assess the association of the CBI with treatment response and patient characteristics.

Main Methods:

• Retrospective multicenter cohort study of adult patients with non-anoxic SE.
• Data collected from Odense University Hospital (Denmark) and Erasme Hospital (Belgium).
• Uni- and multivariable analyses assessed the association of CBI with outcomes; log-rank test compared survival.

Main Results:

• The study included 537 patients; median CBI was 3 in both cohorts.
• CBI correlated with treatment response, SE duration, comorbidities, and etiology.
• CBI independently predicted in-hospital mortality; cardiovascular, respiratory, and renal complications were key predictors.

Conclusions:

• The Complication Burden Index (CBI) is a valid tool for assessing SE treatment complications.
• CBI and specific complications (cardiovascular, respiratory, renal) are linked to in-hospital mortality.
• CBI did not independently predict 6-month mortality in discharged patients, indicating temporal effects.