Recurrence of status epilepticus: Prognostic role and outcome predictors.

Détails

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Etat: Public
Version: Author's accepted manuscript
ID Serval
serval:BIB_B86D8411DDC9
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Recurrence of status epilepticus: Prognostic role and outcome predictors.
Périodique
Epilepsia
Auteur(s)
Tsetsou S., Novy J., Rossetti A.O.
ISSN
1528-1167 (Electronic)
ISSN-L
0013-9580
Statut éditorial
Publié
Date de publication
2015
Peer-reviewed
Oui
Volume
56
Numéro
3
Pages
473-478
Langue
anglais
Résumé
OBJECTIVE: Predictors of morbidity and mortality after status epilepticus (SE) have been studied extensively in hospital- and population-based cohorts. However, little attention has been directed toward SE recurrence after an incident episode. We investigated clinical and demographic characteristics of patients presenting SE recurrence and its specific prognostic role.
METHODS: In this observational cohort study, we screened our prospective registry of consecutive adults with SE between April 2006 and February 2014. Demographic and clinical data were compared between incident and recurrent SE episodes; risk of SE recurrence was assessed through survival analysis, and the prognostic role of SE recurrence with multivariable logistic regressions.
RESULTS: Of the incident cohort (509 patients), 68 (13%) experienced recurrent SE. The cumulative recurrence rate over 4 years was 32%. Recurrence risk was significantly reduced after an acute SE etiology (hazard ratio [HR] 0.5, 95% confidence interval [CI] 0.31-0.82; p = 0.005), and was borderline increased in women (HR 1.59, 95% CI 0.97-2.65; p = 0.06). Although recurrent SE episodes showed lower morbidity and mortality, prognosis was independently related to Status Epilepticus Severity Score (STESS) and potentially fatal etiology, but not to SE recurrence.
SIGNIFICANCE: This study provides class III evidence that SE recurrence involves a significant proportion of patients, and that recurrence risk is independently associated with chronic etiology and to a lesser extent with female gender. However, contrary to underlying cause and SE severity, SE recurrence per se does not independently correlate with outcome. Early identification of patients at higher risk of SE recurrence may influence their management during follow-up.
Pubmed
Web of science
Open Access
Oui
Création de la notice
19/03/2015 11:13
Dernière modification de la notice
20/08/2019 16:26
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