A national database of incidence and treatment outcomes of status epilepticus in Thailand

Abstract

Status epilepticus (SE) is a serious neurological condition. The national database of SE in Thailand and other developing countries is limited in terms of incidence and treatment outcomes. This study was conducted on the prevalence of status epilepticus (SE). The study group comprised of adult inpatients (over 18 years old) with SE throughout Thailand. SE patients were diagnosed and searched based on ICD 10 (G41) from the national database. The database used was from reimbursement documents submitted by the hospitals under the three health insurance systems, namely, the universal health coverage insurance, social security, and government health welfare system during the fiscal year 2010. We found 2190 SE patients receiving treatment at hospitals (5.10/100 000 population). The average age was 50.5 years and 1413 patients were males (64.5%). Mortality rate was 0.6 death/100 000 population or 11.96% of total patients. Significant factors associated with death or a nonimproved status at discharge were type of insurance, hospital level, chronic kidney disease, having pneumonia, having shock, on mechanical ventilator, and having cardiopulmonary resuscitation. In conclusion, the incidence of SE in Thailand was 5.10/100 000 population with mortality rate of 0.6/100 000 population.

Preliminary results of the global audit of treatment of refractory status epilepticus

“…Status epilepticus affects 5-41/100,000 people annually and has a mortality rate up to 38% [1][2][3][4] and over 60% occurring after prolonged seizures duration [1]. Between 31-43% of cases will be refractory to first-line and second-line treatments [5,6], and this subset, termed refractory status epilepticus, has a mortality rate of 30% [7,8].…”

The Clinical Characteristics and Prognostic Analysis of Status Epilepticus in Northeast China

“…The overall mortality rate in the US is approximately 20% [4], in Thailand it is about 11.96% [5], and in Brazil it can reach up to 36.2% [11]. Hay et al [6] performed a retrospective study of patients admitted to an intensive care unit with the primary admission diagnosis of SE in ­Australia and New Zealand, and they found that mortality decreased greatly from 2.6% in 2000 to 0.75% in 2013.…”

Status epilepticus in the elderly patients: A national data study in Thailand

“…Only 45% of the patients in the study from central Thailand were 60-90 years of age [14]. We found the national mortality rate of SE to be 11.96% for all age groups [19], which was lower than in this elderly population (14.5%). Several factors were independently associated with poor outcomes at discharge (Table 3).…”

“…This study is a subgroup analysis of the previous study [31]. Another national study included all adult SE patients with all types of health insurance and treated in 2010 [19] which may be a part of this study. Some limitations exist, however.…”

“…SE was presented in 30% of acute seizures in the elderly with a mortality rate of 40% particularly refractory SE [8,20,28,29]. In addition, primary care hospitals have a limited amount of anti-epileptic drugs to control refractory or non-convulsive SE [17,19,30]. The most common co-morbid conditions of SE in elderly patients were cerebrovascular disease at 45%-50% [2,5,31].…”