Role of comorbidities in outcome prediction after status epilepticus.

Details

Ressource 1Download: BIB_422621635D10.P001.pdf (1541.80 [Ko])
State: Public
Version: Author's accepted manuscript
Serval ID
serval:BIB_422621635D10
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Role of comorbidities in outcome prediction after status epilepticus.
Journal
Epilepsia
Author(s)
Alvarez V., Januel J.M., Burnand B., Rossetti A.O.
ISSN
1528-1167 (Electronic)
ISSN-L
0013-9580
Publication state
Published
Issued date
2012
Peer-reviewed
Oui
Volume
53
Number
5
Pages
e89-e92
Language
english
Notes
Publication types: Journal Article
Abstract
Status epilepticus (SE) is associated with significant mortality and morbidity. A reliable prognosis may help better manage medical resources and treatment strategies. We examined the role of preexisting comorbidities on the outcome of patients with SE, an aspect that has received little attention to date. We prospectively studied incident SE episodes in 280 adults occurring over 55 months in our tertiary care hospital, excluding patients with postanoxic encephalopathy. Different models predicting mortality and return to clinical baseline at hospital discharge were compared, which included demographics, SE etiology, a validated clinical Status Epilepticus Severity Score (STESS), and comorbidities (assessed with the Charlson Comorbidity Index) as independent variables. The overall short-term mortality was 14%, and only half of patients returned to their clinical baseline. On bivariate analyses, age, STESS, potentially fatal etiologies, and number of preexisting comorbidities were all significant predictors of both mortality and return to clinical baseline. As compared with the simplest predictive model (including demographics and deadly etiology), adding SE severity and comorbidities resulted in an improved predictive performance (C statistics 0.84 vs. 0.77 for mortality, and 0.86 vs. 0.82. for return to clinical baseline); comorbidities, however, were not independently related to outcome. Considering comorbidities and clinical presentation, in addition to age and etiology, slightly improves the prediction of SE outcome with respect to both survival and functional status. This analysis also emphasizes the robust predictive role of etiology and age.
Keywords
Adult , Age Factors , Aged , Comorbidity* , Female , Humans , Longitudinal Studies , Male , Middle Aged , Predictive Value of Tests , Status Epilepticus/epidemiology* , Status Epilepticus/mortality , Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
25/05/2012 14:36
Last modification date
20/08/2019 13:43
Usage data