Characteristics and acute outcomes of ICU patients with initial presentation of seizure

Tobochnik, Steven; Gutierrez, Camilo; Jacobson, Mercedes P.

doi:10.1016/j.seizure.2015.01.016

Cited by 6 publications

(5 citation statements)

References 10 publications

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“…The relevance of seizures at presentation and relationship with in-hospital mortality was evaluated in a retrospective cohort study that recruited 247 patients presenting with seizures to the emergency department and admitted to the ICU for treatment. 14 In this subgroup of patients, ICH was detected as a possible underlying cause of the seizures in 36 of 247 patients (14.5%). Overall, in-hospital death occurred in 7.7%.…”

Section: Risk Stratification and Neurocritical Care Or Intensive Carementioning

confidence: 81%

“…After screening for eligibility, 37 articles were excluded and 14 articles were selected ( Fig. 1) and categorized into the following four subcategories: risk stratification and NCC or ICU treatment, [13][14][15][16] haemodynamic management, 17-22 mechanical ventilation, 23 24 and pharmacological neuroprotection 25 26 (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Recent literature provides insights on risk stratification of ICH in patients receiving non-vitamin K-antagonist anticoagulants [new oral anticoagulants (NOACs)] and in patients presenting with seizures, co-morbidity and complications associated with ICU treatment, and on limited benefit of ICU treatment in lowrisk patients presenting with post-traumatic ICH. [13][14][15][16] Clinical characteristics and the relationship with arterial blood pressure of ICH associated with chronic use of NOACs is reported in a retrospective cohort study in six patients (five receiving rivaroxaban and one apixaban). 13 In these patients, the mean time to onset was 146 ( 112) days after starting NOACs, and mean systolic arterial pressure (SAP; recorded 1 month before ICH) was 138 (16) mm Hg.…”

Section: Risk Stratification and Neurocritical Care Or Intensive Carementioning

confidence: 99%

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Neurocritical care for intracranial haemorrhage: a systematic review of recent studies

Badenes

Bilotta

2015

British Journal of Anaesthesia

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Intracerebral haemorrhage (ICH) is associated with significant early mortality (up to 50% at 30 days) and long-term morbidity (with permanent neurological deficits in 75-80% of patients) and represents a serious health issue worldwide. The past decade has seen a dramatic increase in clinical research on ICH diagnosis and treatment that has led to revision of the guidelines for the diagnosis and management of ICH from the American Heart Association and American Stroke Association in 2013. This systematic review reports recent clinical evidence (original studies published between September 2013 and July 2015) related to neurocritical care and intensive care unit management of patients with ICH. All but one publication included in this review report original studies related to managment of patients with intracerebral or subarachnoid haemorrhage. These include insights on risk stratification and neurocritical care or intensive care unit treatment, management of haemodynamic variables and mechanical ventilation (goal-directed fluid therapy, advanced haemodynamic monitoring, and avoidance of hyperoxia and hyperventilation), and pharmacological neuroprotection.

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Section: Risk Stratification and Neurocritical Care Or Intensive Carementioning

confidence: 81%

Section: Resultsmentioning

confidence: 99%

Section: Risk Stratification and Neurocritical Care Or Intensive Carementioning

confidence: 99%

See 1 more Smart Citation

Neurocritical care for intracranial haemorrhage: a systematic review of recent studies

Badenes

Bilotta

2015

British Journal of Anaesthesia

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“…The seven studies that were not suitable for prevalence‐of‐intubation pooling had cohorts that consisted entirely of those that were intubated, making a calculation of prevalence impossible . A comprehensive listing of the 46 articles with a description of study characteristics, prevalence‐bias assessment, and intubation prevalence are shown in Table S1 …”

Section: Resultsmentioning

confidence: 99%

Review article: Emergency endotracheal intubation in non‐traumatic brain pathologies: A systematic review and meta‐analysis

Fouche

Stein

Jennings

et al. 2019

Emerg Medicine Australasia

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Endotracheal intubation is an advanced airway procedure performed in the ED and the out-ofhospital setting for acquired brain injuries that include non-traumatic brain pathologies such as stroke, encephalopathies, seizures and toxidromes. Controlled trial evidence supports intubation in traumatic brain injuries, but it is not clear that this evidence can be applied to nontraumatic brain pathologies. We sought to analyse the impact of emergency intubation on survival in non-traumatic brain pathologies and also to quantify the prevalence of intubation in these pathologies. We conducted a systematic literature search of Medline, Embase and the Cochrane Library. Eligibility, data extraction and assessment of risk of bias were assessed independently by two reviewers. A bias-adjusted metaanalysis using a quality-effects model pooled prevalence of intubation in non-traumatic brain pathologies. Forty-six studies were included in this systematic review. No studies were suitable for meta-analysis the primary outcome of survival. Thirtynine studies reported the prevalence of intubation in non-traumatic brain pathologies and a meta-analysis showed that emergency intubation was used in 12% (95% CI 0-33) of pathologies. Endotracheal intubation was used commonly in haemorrhagic stroke 79% (95% CI 47-100) and to a lesser extent for seizures 18% (95% CI 10-27) and toxidromes 25% (95% CI 6-48). This systematic review shows that there is no high-quality clinical evidence to support or refute emergency intubation in non-traumatic brain pathologies. Our analysis shows that intubation is commonly used in non-traumatic brain pathologies, and the need for rigorous evidence is apparent.

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“…Although the patients’ complaints about having seizures are frequently seen in the ED, they vary widely in terms of frequency, severity, and prognostic significance. 1 , 2 Seizure constitutes 1% of annual emergency admissions in the USA. 3 It has been reported that 28% of patients with epilepsy admit to EDs for treatment purposes every year.…”

mentioning

confidence: 99%

Characteristics of the patients who admitted to the emergency department with seizures and the factors affecting the frequency of admission

Bozali

Köse

Babuş

et al. 2021

NSJ

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Objectives: To determine the features of patients applying to the emergency department )ED( with seizures and the factors affecting the frequency of admission. Methods: This study was designed as a retrospective, cross-sectional study. The demographic and clinical Original Article characteristics, admission frequencies, diagnostic tests )laboratory and imaging methods( of the patients who were older than 18 years old and admitted to the ED between January 1, 2014 and January 1, 2017 with seizures were analyzed. Results: The study included 867 patients with seizures. A comparison of the number of admissions by gender revealed a statistical significance )p=0.007(. The number of admissions and the number of seizures until the time of admission were compared and found a statistical significance )p=0.002(. In the logistic regression analysis of the factors affecting the frequency of admissions, seizure character [OR: 4.404 )%95 CI:1.761-11.015(, p=0.002], comorbidity [OR: 2.021 )%95 CI:1.407-2.904(, p<0.001], hospitalization [OR:1.893 )%95 CI: 1.259-2.847(, p=0.002], concomitant injury [OR: 2.013 )%95 CI: 1.016-3.988(, p=0.045], drug use )p<0.001(, and possible etiology cerebrovascular disease )CVD( [OR: 2.763 )%95 CI: 1.327-5.752(, p=0.007] were risk factors for frequent admission of patients applying to ED with seizures. Conclusion: Seizure character )first and known seizure(, comorbidity status, hospitalization, concomitant injury, anti-epileptic drugs use, and possible etiology CVD are risk factors affecting the frequency of admission with seizure.

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Characteristics and acute outcomes of ICU patients with initial presentation of seizure

Abstract: Patients presenting to the ED with and without SE requiring ICU admission may have similar acute outcomes, yet differ in risk factors and seizure etiologies.

Cited by 6 publications

References 10 publications

Neurocritical care for intracranial haemorrhage: a systematic review of recent studies

Neurocritical care for intracranial haemorrhage: a systematic review of recent studies

Review article: Emergency endotracheal intubation in non‐traumatic brain pathologies: A systematic review and meta‐analysis

Characteristics of the patients who admitted to the emergency department with seizures and the factors affecting the frequency of admission

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