Super-refractory status epilepticus in West China

Tian, Linyu; Li, Y.; Xue, Xindong; Wu, Mark; Liu, F.; Hao, Xiaoting; Zhou, Dong

doi:10.1111/ane.12336

Cited by 32 publications

(36 citation statements)

References 22 publications

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“…The concept of SRSE was introduced a few years ago and requires an SE that continues or recurs ≥24 h after the onset of anesthetic therapy and includes those cases in which SE recurs on the reduction or withdrawal of anesthesia. Although the transition from nonrefractory to refractory SE may be minor, and merely indicates that a patient needs one additional intravenous AED to stop SE, the SRSE is, by definition, always characterized by the failure of initial anesthetic therapy to stop SE and by a duration of ventilation of >24 h. SRSE occurs in approximately 12–26% and RSE in 14–57% of all cases of SE . Our results of a relative prevalence of SRSE of 9.7% and of RSE of 50.1% are in line with the results of these studies.…”

Section: Discussionsupporting

confidence: 90%

Costs and cost‐driving factors for acute treatment of adults with status epilepticus: A multicenter cohort study from Germany

et al. 2016

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Section: Discussionsupporting

confidence: 90%

Costs and cost‐driving factors for acute treatment of adults with status epilepticus: A multicenter cohort study from Germany

et al. 2016

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“…The 3-month mortality rates for non-RSE, RSE, and SRSE were 18.2, 20.0, and 45.5% respectively. The mortality rates of RSE and SRSE in our study are a little higher than results from one German study [14] but were consistent with the results of one study from West China [15]. Forty-two patients were lost in the follow-up for evaluating DRE development (17 cases lost until September 2012, another 25 cases lost until November 2017), 1 patient was excluded due to lack of treatment compliance.…”

Section: Study Population and Outcomessupporting

confidence: 89%

Early Predictors of Drug-Resistant Epilepsy Development after Convulsive Status Epilepticus

et al. 2018

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Background: Drug-resistant epilepsy (DRE) is a common and serious consequence of convulsive status epilepticus (CSE). Little is known on the early prediction of DRE development after CSE. Our aim was to identify independent DRE predictors in patients with CSE. Methods: One hundred and forty consecutive patients identified with CSE in a tertiary academic hospital between March 2008 and January 2015 were reviewed. Demographics, clinical features, serum albumin neuroimaging, and electroencephalogram characteristics were collected and analyzed. Independent predictors of DRE were identified using multivariate logistic regression. The receiver operating characteristic (ROC) curve was used to quantify the predictive validity of all the risk factors. Results: After a median 62-month observation period, 91 patients were enrolled into this study. Thirty-seven (40.7%) patients did not have DRE, 22 (24.2%) developed DRE, and 32 (35.2%) were dead. History of epilepsy (OR 9.17, 95% CI 1.77–49.22, p = 0.010), status epilepticus duration ≥24 h (OR 4.82, 95% CI 1.04–22.37, p = 0.044), and cortical or hippocampal abnormalities on neuroimaging (OR 9.49, 95% CI 1.90–47.50, p = 0.006) were independent predictors of DRE after CSE. A combination of these 3 variables yielded an area under the ROC curve of 0.77 (0.65–0.89). Conclusions: History of epilepsy, longer SE duration, and cortical or hippocampal abnormalities on neuroimaging are early predictors for the development of DRE after CSE. Further studies are needed to assess whether a more aggressive treatment will reduce the likelihood of DRE development in these high-risk patients.

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“…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. The relevant studies in China revealed mortality rates of 16% in Hong Kong [7] and 7.1% in west China [12]. In the current study, we found that the mortality of SE in northeast China was 6.73%.…”

Section: Discussionsupporting

confidence: 51%

“…Whether age contributes to the progression of RSE/SRSE is still controversial. Some scholars proposed age as a high risk factor of RSE [19, 20], while others did not find an association between age and occurrence of RSE [12]. In our study, we noted a significant difference in the average age of the 2 groups, strongly suggesting that age is an independent risk factor for RSE.…”

Section: Discussioncontrasting

confidence: 45%

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

2017

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Objective: Status epilepticus (SE) is a neurological emergency that may cause severe neurological deficiency and even death. The aim of this study was to analyze the clinical characteristics and prognosis of SE in northeast China. Additionally, the etiology and classification are discussed. Materials and Methods: We retrospectively collected the clinical profiles of patients diagnosed with SE in the Epilepsy Center of Jilin University between January 2011 and May 2015. The causes and clinical courses were investigated. The individuals were followed up by visit or telephone, and the prognoses were analyzed. Results: A total of 223 patients with SE were enrolled, including 134 cases with non-refractory SE (NRSE) and 89 cases with refractory or super-refractory SE (RSE/SRSE). Fifteen patients died during hospitalization, yielding a mortality of 6.73%; 11 of them succumbed to multiple organ dysfunction syndrome (MODS). Statistical analysis showed significant differences in age, family history of epilepsy, and the incidence of non-convulsive SE (NCSE) between the NRSE group and RSE/SRSE group (p < 0.05). We found no significant differences in the causes of SE (central nervous system infection, autoimmune encephalitis, and epilepsy) between these 2 groups. Conclusion: In northeast China, SE is associated with relatively lower mortality, and MODS is the major cause of death. Older age and NCSE are risk factors predicting potential progression to RSE. Central nervous system infection, autoimmune encephalitis, and epilepsy were common causes of SE, but there was no significant association between any of these causes and the occurrence of RSE.

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Super-refractory status epilepticus in West China

Abstract: This study was the first to use the statistical percentage of SRSE. Approximately 12.2% of SE cases will result in SRSE, which is a challenging medical situation for doctors. Patients with first episodes and acute encephalitis were also prone to develop SRSE.

Cited by 32 publications

References 22 publications

Costs and cost‐driving factors for acute treatment of adults with status epilepticus: A multicenter cohort study from Germany

Costs and cost‐driving factors for acute treatment of adults with status epilepticus: A multicenter cohort study from Germany

Early Predictors of Drug-Resistant Epilepsy Development after Convulsive Status Epilepticus

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

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