Epidemiology-Based Mortality Score is Associated with Long-Term Mortality after Status Epilepticus.
Neurocrit Care
; 31(1): 135-141, 2019 08.
Article
en En
| MEDLINE
| ID: mdl-30607827
ABSTRACT
BACKGROUND/OBJECTIVE:
Status epilepticus (SE) is a life-threatening condition with a high long-term mortality. The correct prediction of the individual patient's outcome is crucial for stratifying treatment. Status epilepticus severity score (STESS) and the epidemiology-based mortality score (EMSE) are well established for predicting in-hospital mortality; however, scores indicating long-term mortality are lacking. We here studied the association of both scores with mortality after discharge and long-term mortality.METHODS:
In this retrospective cohort study of adult patients with incident, non-anoxic, first-time SE (from 01/2008 to 12/2014), STESS, EMSE-EACE (etiology-age-comorbidity-EEG), demographic data, modified Rankin Scale at discharge, treatment, date of diagnosis, and date of death were determined based on electronic patients charts.RESULTS:
A total of 129 patients with a median follow-up of 24.8 months were included. We found no significant difference between STESS and EMSE-EACE in predicting in-hospital and 3 months mortality. At end-of-study, EMSE-EACE with a cutoff of ≥ 64 showed the best association with overall survival. At last follow-up, only 15.7% (8 out of 51) of the patients with EMSE ≥ 64 were alive as compared to 32.4% (24 out of 74) of the patients with STESS ≥ 3. Median survival of patients with EMSE-EACE ≥ 64 and EMSE-EACE < 64 was 6.4 months (95% confidence interval (CI) 2.3-15.3 months) and 35.8 months (CI 32.8-37.9 months), respectively. In the subgroup of patients that were discharged alive from the hospital, EMSE-EACE was highly significantly associated with mortality (p < 0.001) after discharge. In the same patients, STESS with a cutoff of STESS ≥ 3 reached only borderline significance (p = 0.04), STESS with a cutoff of STESS ≥ 4 did not reach statistical significance (p = 0.23). Exploratory analyses of different EMSE components unveiled a strong association of etiology with in-house mortality but not with long-term survival. In patients discharged alive from the hospital, only comorbidity and age remained significantly associated with long-term mortality.CONCLUSIONS:
In our cohort, EMSE-EACE was significantly associated with long-term survival after discharge.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Estado Epiléptico
Tipo de estudio:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Límite:
Adolescent
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Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Neurocrit Care
Asunto de la revista:
NEUROLOGIA
/
TERAPIA INTENSIVA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Dinamarca