Appropriate drug treatment for status epilepticus does not influence its prognosis
Détails
ID Serval
serval:BIB_396F17AC1502
Type
Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
Sous-type
Abstract (résumé de présentation): article court qui reprend les éléments essentiels présentés à l'occasion d'une conférence scientifique dans un poster ou lors d'une intervention orale.
Collection
Publications
Institution
Titre
Appropriate drug treatment for status epilepticus does not influence its prognosis
Titre de la conférence
137th Annual Meeting of the American Neurological Association
Adresse
Boston, United-States, October 7-9, 2012
ISBN
1531-8249
ISSN-L
0364-5134
Statut éditorial
Publié
Date de publication
2012
Volume
72
Série
Annals of Neurology
Pages
S59
Langue
anglais
Résumé
Objective: Status epilepticus (SE) prognosis, is mostly
related to non-modifiable factors (especially age, etiology),
but the specific role of treatment appropriateness (TA) has
not been investigated.
Methods: In a prospective cohort with incident SE
(excluding postanoxic), TA was defined, after recent European
recommendations, in terms of drug dosage (630%
deviation) and sequence. Outcome at hospital discharge was
categorized into mortality, new handicap, or return to
baseline.
Results: Among 225 adults, treatment was inappropriate
in 37%. In univariate analyses, age, etiology, SE severity and
comorbidity, but not TA, were significantly related to outcome.
Etiology (95% CI 4.3-82.8) and SE severity (95%
CI 1.2-2.4) were independent predictors of mortality, and
of lack of return to baseline conditions (etiology: 95% CI
3.9-14.0; SE severity: 95% CI 1.4-2.2). Moreover, TA did
not improve outcome prediction in the corresponding ROC
curves.
Conclusions: This large analysis suggests that TA plays a
negligible prognostic role in SE, probably reflecting the outstanding
importance of the biological background. Awaiting
treatment trials in SE, it appears questionable to apply further
resources in refining treatment protocols involving
existing compounds; rather, new therapeutic approaches
should be identified and tested.
related to non-modifiable factors (especially age, etiology),
but the specific role of treatment appropriateness (TA) has
not been investigated.
Methods: In a prospective cohort with incident SE
(excluding postanoxic), TA was defined, after recent European
recommendations, in terms of drug dosage (630%
deviation) and sequence. Outcome at hospital discharge was
categorized into mortality, new handicap, or return to
baseline.
Results: Among 225 adults, treatment was inappropriate
in 37%. In univariate analyses, age, etiology, SE severity and
comorbidity, but not TA, were significantly related to outcome.
Etiology (95% CI 4.3-82.8) and SE severity (95%
CI 1.2-2.4) were independent predictors of mortality, and
of lack of return to baseline conditions (etiology: 95% CI
3.9-14.0; SE severity: 95% CI 1.4-2.2). Moreover, TA did
not improve outcome prediction in the corresponding ROC
curves.
Conclusions: This large analysis suggests that TA plays a
negligible prognostic role in SE, probably reflecting the outstanding
importance of the biological background. Awaiting
treatment trials in SE, it appears questionable to apply further
resources in refining treatment protocols involving
existing compounds; rather, new therapeutic approaches
should be identified and tested.
Création de la notice
12/03/2013 17:47
Dernière modification de la notice
20/08/2019 13:29
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