Association of early general anesthesia with outcome in adults with status epilepticus: A propensity-matched observational study.
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UNIL restricted access
State: Public
Version: Author's accepted manuscript
License: Not specified
Serval ID
serval:BIB_2972BF8AACD8
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Association of early general anesthesia with outcome in adults with status epilepticus: A propensity-matched observational study.
Journal
Epilepsia
ISSN
1528-1167 (Electronic)
ISSN-L
0013-9580
Publication state
In Press
Peer-reviewed
Oui
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Publication Status: aheadofprint
Abstract
General anesthesia (GA) earlier than recommended (as first- or second-line treatment) was recently described to improve status epilepticus (SE) outcome. We aimed to assess the impact of early GA on outcome in matched groups. Data from a multicenter, prospective cohort of 1179 SE episodes in 1049 adults were retrospectively analyzed. Incident SE episodes were categorized as "early anesthesia" (eGA; GA as first- or second-line treatment) or "non-early anesthesia" (neGA; GA after second-line treatment or not at all). Using propensity score matching, eGA episodes were paired 1:4 with neGA episodes. We assessed survival, functional outcomes at discharge (good: modified Rankin Scale = 0-2 or no worsening), SE cessation rate, SE duration, and hospital stay. Among 1049 SE episodes, 55 (5.2%) received eGA, and 994 constituted the neGA group; 220 represented the matched controls. Patients receiving eGA were younger (median = 63, interquartile range [IQR] = 56-76 vs. median = 70, IQR = 54-80 years, p = .004), had deeper consciousness impairment (80% vs. 40% stuporous/comatose, p < .001), and had more severe SE forms (89% vs. 54% generalized convulsive SE/nonconvulsive SE in coma, p < .001). Mortality, functional outcome, SE cessation rate, and duration of SE and hospital stay were similar between the eGA group and matched controls. We conclude that early anesthesia for SE treatment did not influence prognosis.
Keywords
antiseizure medication, intubation, mortality, refractory status epilepticus, seizure
Pubmed
Web of science
Create date
02/12/2024 14:53
Last modification date
20/12/2024 7:07