定期出院和 status epilepticus:一个批判性的重新评估
Francesco Misirocchi1, Pia De Stefano2, Alessandro Zilioli1
1Unit of Neurology, Department of Medicine and Surgery, University of Parma, Parma, Italy.
概括
在 status epilepticus (SE) 期间的周期性出院 (PDs) 不能预测结果. 然而,SE解决后发生的PD与预后不佳有关,改善了修改后的EMSE得分,以更好地评估患者.
科学领域:
- 神经学 神经学
- 发病学 (Epileptology) 是一个专业的学科.
- 临床神经生理学 临床神经生理学
背景情况:
- 在状态 (SE) 中,定期排放 (PDs) 历史上与负面结果有关.
- 基于流行病学的SE死亡率 (EMSE) 包括PD作为预后EEG特征,但证据是相互矛盾的.
研究的目的:
- 评估SE期间和之后发生的间接性PD的预后意义.
- 评估区分PD时间对预后模型的影响.
主要方法:
- 189名非低氧性-缺血性SE患者的回顾性分析与EEG数据 (2020-2023年).
- 在SE (SE-PDs) 期间检查的间歇性PD和SE解决后24-72小时的PD (后SE-PDs).
- 住院死亡是主要的结果指标.
主要成果:
- SE-PDs与住院死亡没有关联.
- 在多重回归分析后,后SE-PDs与预后不良显著相关.
- 与原始EMSE相比,仅使用后SE-PDs (mEMSE) 的修改EMSE得分显示AUC (0.803 vs 0.751),特异性 (68% vs 52%) 和准确性 (73% vs 63%) 得到改善.
结论:
- 在SE期间的间接PD不能预测结果.
- 在SE解决后持续或出现超过24小时的PD与不良预后密切相关.
- 区分PD时间可以改善预后评估,并提高EMSE得分的准确性.
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