Factors Associated With Functional Outcomes in Status Epilepticus Patients

Abstract

Background. Status epilepticus is one of the most dangerous neurological emergencies that require immediate treatment to prevent further neurological damage due to high mortality (ranging from 7.6 to 39%). Glasgow outcome scale (GOS) is considered a valid, practical and reliable tool to measure functional outcomes of patients with status epilepticus. Determining the factors that may influence those outcomes and recognizing them early may help reduce in-hospital mortality for status epilepticus patients and lead to better outcomes. Aim. The aim of this study was to identify the factors influencing functional outcomes of patients with status epilepticus. Methods. A retrospective chart review of 47 patients with status epilepticus who were admitted to Hospital of Lithuanian University of Health Sciences Kaunas Clinics Neurosurgical intensive care unit (NICU) during 2016–2020 was performed. We analysed age, gender, duration of mechanical ventilation (MV), intensity of treatment, presence of infection, length of stay in NICU and in the hospital, circumstances of the seizure (started in-hospital or not). The functional outcomes were determined using GOS. The scores of 4–5 points were considered a “good outcome” for a patient. Statistical analysis was performed with IBM SPSS Statistics 27. The Chi-square and Fisher’s exact tests were used to determine the relationship between variables. A significance level of 0.05 was chosen for testing the statistical hypotheses. Results. The data of 47 patients were analyzed. The mean age was 50.74±17.062 years (range 20–82), 59.6% (n=28) were males and 40.4% (n=19) were females. Average length of stay was 18.86±15.011 days (range 1–59), average NICU time was 4.96±6.769 days (range 0–35). 87.2 % of seizures were generalizedconvulsive. Mortality was 8.511%. 72.3% (n=34) of the patients had good outcomes. Presence of infection was related to worse functional outcomes (χ2=6.546, p=0.011). Shorter hospitalization time in NICU (χ2=5.009, p=0.025) as well as shorter duration of MV (p=0.008) were associated with better GOS scores. Relationships between functional outcomes and intensity of treatment, patients’ age, circumstances of the seizure or type of seizure were not statistically significant (p>0.05). Conclusion. Factors influencing worse outcomes were presence of infection during hospitalization in NICU, longer duration of mechanical ventilation, as well as longer length of stay in NICU. Other factors did not have a statistically significant relationship with functional outcomes of the patients.