Appropriate drug treatment for status epilepticus does not influence its prognosis
Details
Serval ID
serval:BIB_396F17AC1502
Type
Inproceedings: an article in a conference proceedings.
Publication sub-type
Abstract (Abstract): shot summary in a article that contain essentials elements presented during a scientific conference, lecture or from a poster.
Collection
Publications
Institution
Title
Appropriate drug treatment for status epilepticus does not influence its prognosis
Title of the conference
137th Annual Meeting of the American Neurological Association
Address
Boston, United-States, October 7-9, 2012
ISBN
1531-8249
ISSN-L
0364-5134
Publication state
Published
Issued date
2012
Volume
72
Series
Annals of Neurology
Pages
S59
Language
english
Abstract
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.
Create date
12/03/2013 17:47
Last modification date
20/08/2019 13:29
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