Prognositic factors in status epilepticus and prognosis evaluation_Journal of Epilepsy

Authors：

 LIANGYing ,  DENGFen , CHENYang-mei

Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China;

Corresponding?author：

DENGFen, Email: dengf1996@126.com

Keywords：

Status epilepticus; Prognosis; STESS Score

DOI：

10.7507/2096-0247.20150004

Video：

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Objective To analyze the prognosis factors in status epilepticus and confirm the external validity of the Status Epilepticus Severity Score (STESS) prediction functions for outcome in patients with statusepilepticus. Methods Retrospectively, collecting prognosis factors in status epilepticus of 50 patients. These factors include gender, age, SE aetiology, seizure type at SE onset, history of prior seizures or epilepsy, level of consciousness, duration of SE, albumin and infection. Using STESS score to evaluate the prognosis of patients, then evaluate the effectiveness of the STESS score. Results 1. Single factor analysis:age,history of prior seizures or epilepsy, level of consciousness and infection were prognosis factors in status epilepticus (P<0.05). Gender, SE aetiology, seizure type at SE onset and albumin were not prognosis factors (P>0.05). Multivariablelogistic regression models selected two factors:duration of SE (OR3.645), level of consciousness (OR2.877). 2. 28 status epilepticus patient in the STESS 0-2 group were all alive. 10 status epilepticus patients in the STESS 3-6 group were died (45.4%), 12 patient were alive (54.6%). There were significant differences among the prognostic of patienst in different groups (P<0.01). The receiver operating characteristic curve for prediction of death by the STESS Score had an area under the curve of 0.92. The optimal cut-off point is 3. Conclusion Age, history of prior seizures or epilepsy, level of consciousness, duration of SE and infection were prognosis factors in status epilepticus. Level of consciousness and duration of SE were the directly related factors of the prognosis of status epilepticus. STESS score performed reasonable prognositic role on our patients with status epilepticus.

Citation： LIANGYing, DENGFen, CHENYang-mei. Prognositic factors in status epilepticus and prognosis evaluation. Journal of Epilepsy, 2015, 1(1): 28-31. doi: 10.7507/2096-0247.20150004 Copy

1.	?Jenssen S, Gracely EJ, Sperling MR. How long do most seizures last? A systematic comparison of seizures recorded in the epilepsy monitoring unit. Epilepsia, 2006, 47(9):1499-1503.
2.	Chen JWY, Wasterlain CG. Status epilepticus:pathophysiology and management in adults. The Lancet Neurology, 2006, 5(3):246-256.
3.	Lowenstein DH, Bleck T, Macdonald RL. It's time to revise the definition of status epilepticus. Epilepsia, 1999, 40(1):120-122.
4.	Foreman B, Hirsch LJ. Epilepsy emergencies:diagnosis and management. Neurol Clin, 2012, 30(1):11-41.
5.	Brophy GM, Bell R, Claassen J, et al. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care, 2012, 17(1):3-23.
6.	Sutter R, Kaplan PW, Ruegg S. Outcome predictors for status epilepticus——what really counts. Nat Rev Neurol, 2013, 9(9):525-534.
7.	A RAOLGMT. Status Epilepticus Severity Score (STESS)_a tool to orient early treatment strategy. J Neurol, 2008, 255(10):1561-1566.
8.	Dham BS, Hunter K, Rincon F. The epidemiology of status epilepticus in the United States. Neurocrit Care, 2014, 20(3):476-483.
9.	Rudin D, Grize L, Schindler C, et al. High prevalence of nonconvulsive and subtle status epilepticus in an ICU of a tertiary care center:a three-year observational cohort study. Epilepsy Res, 2011, 96(1):140-150.
10.	Rossetti AO, Logroscino G, Bromfield EB. A clinical score for prognosis of status epilepticus in adults. Neurology, 2006, 66(11):1736-1738.
11.	Legriel S, Mourvillier B, Bele N, et al. Outcomes in 140 critically ill patients with status epilepticus. Intensive Care Med, 2008, 34(3):476-480.
12.	Sutter R, Marsch S, Fuhr P, et al. Mortality and recovery from refractory status epilepticus in the intensive care unit:a 7-year observational study. Epilepsia, 2013, 54(3):502-511.
13.	Bausell R, Svoronos A, Lennihan L, et al. Recovery after severe refractory status epilepticus and 4 months of coma. Neurology, 2011, 77(15):1494-1495.
14.	Fernandez-Torre JL, Kaplan PW, Rebollo M, et al. Ambulatory non-convulsive status epilepticus evolving into a malignant form. Epileptic Disord, 2012, 14(1):41-50.
15.	Koubeissi M, Alshekhlee A. In-hospital mortality of generalized convulsive status epilepticus:a large US sample. Neurology, 2007, 69(9):886-893.
16.	Sutter R, Tschudin-Sutter S, Grize L, et al. Associations between infections and clinical outcome parameters in status epilepticus:a retrospective 5-year cohort study. Epilepsia, 2012, 53(9):1489-1497.
17.	Mayer SA, Claassen J, Lokin J, et al. Refractory status epilepticus:frequency, risk factors, and impact on outcome. Arch Neurol, 2002, 59(2):205-210.
18.	Sutter R, Grize L, Fuhr P, et al. Acute-phase proteins and mortality in status epilepticus:a 5-year observational cohort study. Crit Care Med, 2013, 41(6):1526-1533.
19.	Sutter R, Kaplan PW, Marsch S, et al. Early predictors of refractory status epilepticus:an international two-center study. Eur J Neurol, 2014,doi:10.1 111/ene. 12531.
20.	Sutter R, Kaplan PW, Ruegg S. Independent external validation of the status epilepticus severity score. Crit Care Med, 2013, 41(12):475-479.

1. ?Jenssen S, Gracely EJ, Sperling MR. How long do most seizures last? A systematic comparison of seizures recorded in the epilepsy monitoring unit. Epilepsia, 2006, 47(9):1499-1503.
2. Chen JWY, Wasterlain CG. Status epilepticus:pathophysiology and management in adults. The Lancet Neurology, 2006, 5(3):246-256.
3. Lowenstein DH, Bleck T, Macdonald RL. It's time to revise the definition of status epilepticus. Epilepsia, 1999, 40(1):120-122.
4. Foreman B, Hirsch LJ. Epilepsy emergencies:diagnosis and management. Neurol Clin, 2012, 30(1):11-41.
5. Brophy GM, Bell R, Claassen J, et al. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care, 2012, 17(1):3-23.
6. Sutter R, Kaplan PW, Ruegg S. Outcome predictors for status epilepticus——what really counts. Nat Rev Neurol, 2013, 9(9):525-534.
7. A RAOLGMT. Status Epilepticus Severity Score (STESS)_a tool to orient early treatment strategy. J Neurol, 2008, 255(10):1561-1566.
8. Dham BS, Hunter K, Rincon F. The epidemiology of status epilepticus in the United States. Neurocrit Care, 2014, 20(3):476-483.
9. Rudin D, Grize L, Schindler C, et al. High prevalence of nonconvulsive and subtle status epilepticus in an ICU of a tertiary care center:a three-year observational cohort study. Epilepsy Res, 2011, 96(1):140-150.
10. Rossetti AO, Logroscino G, Bromfield EB. A clinical score for prognosis of status epilepticus in adults. Neurology, 2006, 66(11):1736-1738.
11. Legriel S, Mourvillier B, Bele N, et al. Outcomes in 140 critically ill patients with status epilepticus. Intensive Care Med, 2008, 34(3):476-480.
12. Sutter R, Marsch S, Fuhr P, et al. Mortality and recovery from refractory status epilepticus in the intensive care unit:a 7-year observational study. Epilepsia, 2013, 54(3):502-511.
13. Bausell R, Svoronos A, Lennihan L, et al. Recovery after severe refractory status epilepticus and 4 months of coma. Neurology, 2011, 77(15):1494-1495.
14. Fernandez-Torre JL, Kaplan PW, Rebollo M, et al. Ambulatory non-convulsive status epilepticus evolving into a malignant form. Epileptic Disord, 2012, 14(1):41-50.
15. Koubeissi M, Alshekhlee A. In-hospital mortality of generalized convulsive status epilepticus:a large US sample. Neurology, 2007, 69(9):886-893.
16. Sutter R, Tschudin-Sutter S, Grize L, et al. Associations between infections and clinical outcome parameters in status epilepticus:a retrospective 5-year cohort study. Epilepsia, 2012, 53(9):1489-1497.
17. Mayer SA, Claassen J, Lokin J, et al. Refractory status epilepticus:frequency, risk factors, and impact on outcome. Arch Neurol, 2002, 59(2):205-210.
18. Sutter R, Grize L, Fuhr P, et al. Acute-phase proteins and mortality in status epilepticus:a 5-year observational cohort study. Crit Care Med, 2013, 41(6):1526-1533.
19. Sutter R, Kaplan PW, Marsch S, et al. Early predictors of refractory status epilepticus:an international two-center study. Eur J Neurol, 2014,doi:10.1 111/ene. 12531.
20. Sutter R, Kaplan PW, Ruegg S. Independent external validation of the status epilepticus severity score. Crit Care Med, 2013, 41(12):475-479.

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Prognositic factors in status epilepticus and prognosis evaluation

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