Status epilepticus in Auckland, New Zealand: Incidence, etiology, and outcomes

Bergin, Peter; Brockington, Alice; Jayabal, Jayaganth; Scott, Shona; Litchfield, Rhonda; Roberts, Lindsay R.; Timog, Jerelyn; Beilharz, Erica; Dalziel, Stuart R; Jones, P. G.; Yates, Kim; Thornton, Vanessa; Walker, Elizabeth; Davis, Suzanne L.; Ao, Braden Te; Parmar, Priya; Beghi, Ettore; Rossetti, Andrea O.; Feigin, Valery

doi:10.1111/epi.16277

Cited by 27 publications

(34 citation statements)

References 36 publications

(96 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our “operational SE” incidences of 99.9 evacuations per 100 000/year and 84.5 patients per 100 000/year rank high in the global SE literature (Figure 3A , Table 2 ). 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 Although high SE incidences have also been reported for pediatric or elderly subgroups, they represent the known bimodal epidemiologic peaks of SE. 10 , 11 In contrast, our study excluded the first pediatric peak because patients were 16 years of age or over.…”

Section: Discussionmentioning

confidence: 99%

“…Even after applying more stringent criteria to only consider “confirmed SE” cases, our estimated incidence rates of 77.7 evacuations per 100 000/year and 64.9 patients per 100 000/year still remain elevated. 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 Unfortunately, global literature of SE incidence is biased toward HIC due to a paucity of studies from LMIC, especially on adult patients. However, SE generally occurs more often in LMIC than HIC.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Status epilepticus in the Canadian Arctic: A public health imperative hidden in plain sight

Pavlova

2021

Epilepsia Open

View full text Add to dashboard Cite

Epilepsy (ILAE), and International Bureau for Epilepsy have called epilepsy a public health imperative, with appropriate emphasis on low-to-middle-income countries (LMIC). Although Canada is a high-income country (HIC), income is not distributed uniformly. Furthermore, epilepsy data from the national statistical agency explicitly overlook the Arctic by excluding these territories. A common neurologic emergency, status epilepticus (SE) is a life-threatening manifestation of epilepsy that demands prompt treatment to avoid death and longterm sequelae. Therefore, we examined the rate of SE in a well-defined Canadian Arctic region.Methods: This study takes epidemiologic advantage of the Kivalliq Region's geographical isolation, which is accessible only by air. All SE patients requiring emergency care are consistently flown 1200-1900 kilometers to a single designated hospital in a distinct southern part of Canada for further management and electroencephalography (EEG). We conducted a retrospective database and chart review at this "bottleneck" hospital to identify patients with seizure(s) severe enough to justify emergency airborne medical evacuation over a 11.25-year period from 2009 to 2020. Results:We screened 40 392 EEGs to yield 117 distinct medical evacuations for "operational SE" from 99 patients to derive estimated SE incidences of 99.9 evacuations per 100 000/year and 84.5 patients per 100 000/year. The average time from seizure onset to EEG was 3.2 days. Only 16.2% of SE patients had known epilepsy. For "confirmed SE" cases meeting ILAE criteria, or cases with persistently epileptiform EEG despite days of empiric treatment, estimated incidence was 77.7 evacuations per 100 000/year and 64.9 patients per 100 000/year. Significance: High SE and epilepsy rates in the Canadian Arctic are consistent with LMIC rather than HIC. Our findings demonstrate the paradox of LMICequivalent epilepsy populations camouflaged within HIC. Our findings also highlight the long-standing plight of these under-served and overlooked populations hidden in plain sight.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Status epilepticus in the Canadian Arctic: A public health imperative hidden in plain sight

Pavlova

2021

Epilepsia Open

View full text Add to dashboard Cite

show abstract

“…The wide range of mortality rate ranging from 5% to 39% clearly reflect different methods and patients population in our view. Some studies have included children (thus lowering the incidence in adults) 2,18 or anoxia/hypoxia patients (thus rising it) 2,13,19 . Based on its design, we believe that our study provided reliable epidemiological data relying on current SE definition for non‐urban healthcare system with a large non‐university community hospital.…”

Section: Discussionmentioning

confidence: 93%

“…This population‐based prospective study in an adult population, applies the new 2015 ILAE definition and classification of SE. Bergin et al 18 already used the new 2015 ILAE definition and classification of SE in their 2019 prospective study, but they included children (older than 4 weeks). Moreover, almost 50% of the patients in their study were children (<15 years old).…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of status epilepticus in a non‐urban area in Switzerland

Vijiala

Alvarez

2020

Acta Neurol Scand

View full text Add to dashboard Cite

Status epilepticus represents a medical emergency, and prompt treatment is important. Data on the incidence, etiology, risk factors, and outcomes are required for the decision-making process and for the allocation of resources by institutions and government agencies. The incidence rates of SE is very wide worldwide, ranging from 1.3 per 100,000 per year in Asia 1 to 41 in North America. 2 In Europe, the incidence varies from 9.9 to 27.2. 3,4 Incidence variability may be explained by study design and inclusion criteria. Indeed, some studies are observational cohort based in one or several hospitals. 2,5 Those studies have the advantages of well-collected data, but might suffer from referral bias, and thus, epidemiological data might be difficult to extract. Other studies are based on insurances or administrative data. Those might seems reliable from an epidemiological point of view, but diagnostic coding precision might be variable and data might suffer from imprecisions. Also, most studies rely on tertiary care hospital. The generalizability of these data for community hospital might be difficult. Moreover, in 2015 the new ILAE SE definition has been published and it is important to reassess SE epidemiology and type accordingly.

show abstract

“… 13 , 14 In Auckland, New Zealand, SE (defined as seizures lasting ≥30 minutes) has an age‐adjusted incidence of 15.95 patients/100,000/y. 15 …”

Section: Epidemiologymentioning

confidence: 99%

Epidemiology and Outcomes of Status Epilepticus

Ascoli¹,

Ferlazzo²,

Gasparini³

et al. 2021

IJGM

View full text Add to dashboard Cite

Status epilepticus (SE) is a neurological and medical emergency, defined as a condition resulting either from the failure of the mechanisms responsible of seizure self-limitation or from the initiation of mechanisms which lead to atypically prolonged seizures. Further than death, SE can have long-term consequences, including neuronal injury, depending on the type, cause and duration of seizures with severe associated disabilities. In Europe, SE shows an incidence rate ranging about 9 to 40/100,000/y. In adults, mortality of patients with SE is ~30%, and even higher (up to 40%) in refractory status epilepticus. To date, etiology, duration, presence of comorbidity, level of consciousness, semiology and age are the main clinical predictors of SE outcome.

show abstract

Status epilepticus in Auckland, New Zealand: Incidence, etiology, and outcomes

Cited by 27 publications

References 36 publications

Status epilepticus in the Canadian Arctic: A public health imperative hidden in plain sight

Status epilepticus in the Canadian Arctic: A public health imperative hidden in plain sight

Epidemiology of status epilepticus in a non‐urban area in Switzerland

Epidemiology and Outcomes of Status Epilepticus

Contact Info

Product

Resources

About