Incidence of Status Epilepticus in Adults in Germany: A Prospective, Population‐Based Study

Abstract

Summary:Purpose: To determine the incidence and casefatality rate of status epilepticus (SE) in adults in Hessen, Germany, we performed a prospective, population-based study from July 1997 through June 1999.Methods: All adult patients residing within the zip-code area 35 (area-35) with SE were included. Area-35 had 743.285 adult inhabitants, including 123.353 adult inhabitants of the primary service area of the University Hospital Marburg (PS-area). Patients were reported by 16 hospitals in the area and were prospectively identified and carefully reviewed within 5 days by one of the authors. Based on the crude annual incidence of SE and a rate of underascertainment of 10% determined for the PS-area, the corrected, age-adjusted incidence of SE in area 35, more representative of the population of Germany, was calculated.Results: The crude annual incidence in the PS-area was 15.8/ 100,000 [95% confidence interval (CI), 11.2-21.6]. The calculated, corrected, age-adjusted incidence of SE in area 35 was 17.1/100,000. It was higher for men compared with women (26.1 vs. 13.7) and for those aged 60 years and older (54.5 vs. 4.2/100,000, p < 0.0001). The etiology was mainly remote symptomatic due to cerebrovascular disease. Epilepsy was previously diagnosed in only 50% of the patients. The case-fatality rate was 9.3%.Conclusions: Based on our data, at least 14,000 patients would be affected by SE in Germany, associated with ∼1,300 deaths annually. The incidence of SE in Germany is similar to that found in the white United States population. Furthermore, this study confirms the higher incidence of SE in male patients and in the elderly population. This may be due to a higher incidence of cerebrovascular disease in these subpopulations.

Status Epilepticus after Stroke Is Associated with Increased Long‐term Case Fatality

“…SE was associated with short-term mortality rates of ∼20% (Hauser, 1990;DeLorenzo et al, 1995;Logroscino et al, 1997;Lowenstein and Alldredge, 1998;Knake et al, 2001;Rosenow et al, 2002;Wu et al, 2002). Patient age at diagnosis, etiology of SE (especially anoxia), severity of the underlying disease.…”

“…The SE group consisted of patients from the zip-code area 35-, Hessen, Germany, with 743,258 adult inhabitants (July 1, 1998), who were prospectively screened for an epidemiologic study performed by the Department of Neurology at the University Hospitals in Marburg, Germany (Knake et al, 2001). Included in this study were all patients aged 18 years or older and diagnosed with SE between July 1997 and March 2000.…”

“…The SE group was retrospectively compared with a cohort of consecutive patients identified from the stroke unit registry of the same Department of Neurology that conducted the status study (Knake et al, 2001). Only patients diagnosed between January 1999 and March 1999 with acute IS and ICH, free of any seizures, were included.…”

“…Several studies have described determinants of mortality among patients with SE (Lowenstein and Alldredge, 1998). Most of these studies have investigated mortality after SE up to a maximum follow-up period of <1 year, mostly up to 30 days or to discharge from hospital (Aminoff and Simon, 1980;Barry and Hauser, 1993;Scholtes et al, 1994;Towne et al, 1994;Logroscino et al, 1997).SE was associated with short-term mortality rates of ∼20% (Hauser, 1990;DeLorenzo et al, 1995;Logroscino et al, 1997;Lowenstein and Alldredge, 1998;Knake et al, 2001;Rosenow et al, 2002;Wu et al, 2002). Patient age at diagnosis, etiology of SE (especially anoxia), severity of the underlying disease.…”

Nonconvulsive status epilepticus: a diagnostic and therapeutic challenge in the intensive care setting

“…However, subsequent European studies have shown that CPSE amounts to 16 43% of all SE cases [Vignatelli et al 2003;Knake et al 2001;Coeytaux et al 2000].…”