Factors associated with long-term outcomes in pediatric refractory status epilepticus

被引：19

作者：

Gainza-Lein, Marina ^{[1
,2
,3
]}

Barcia Aguilar, Cristina ^{[1
,4
]}

Piantino, Juan ^{[5
]}

Chapman, Kevin E. ^{[6
,7
]}

Sanchez Fernandez, Ivan ^{[1
,8
]}

Amengual-Gual, Marta ^{[1
,9
]}

Anderson, Anne ^{[10
]}

Appavu, Brian ^{[11
,12
]}

Arya, Ravindra ^{[13
]}

Brenton, James Nicholas ^{[14
]}

Carpenter, Jessica L. ^{[15
]}

Clark, Justice ^{[1
]}

Farias-Moeller, Raquel ^{[16
]}

Gaillard, William D. ^{[15
]}

Glauser, Tracy A. ^{[13
]}

Goldstein, Joshua L. ^{[17
]}

Goodkin, Howard P. ^{[14
]}

Huh, Linda ^{[18
]}

Kahoud, Robert ^{[19
,20
]}

Kapur, Kush ^{[1
]}

Lai, Yi-Chen ^{[21
]}

McDonough, Tiffani L. ^{[22
]}

Mikati, Mohamad A. ^{[23
]}

Morgan, Lindsey A. ^{[24
]}

Nayak, Anuranjita ^{[10
]}

Novotny, Edward, Jr. ^{[24
]}

Ostendorf, Adam P. ^{[25
]}

Payne, Eric T. ^{[26
]}

Peariso, Katrina ^{[13
]}

Reece, Latania ^{[1
]}

Riviello, James ^{[10
]}

Sannagowdara, Kumar ^{[16
]}

Sands, Tristan T. ^{[27
]}

Sheehan, Theodore ^{[1
]}

Tasker, Robert C. ^{[28
]}

Tchapyjnikov, Dmitry ^{[23
]}

Vasquez, Alejandra ^{[1
,29
]}

Wainwright, Mark S. ^{[24
]}

Wilfong, Angus ^{[11
,12
]}

Williams, Korwyn ^{[11
,12
]}

Zhang, Bo ^{[30
,31
]}

Loddenkemper, Tobias ^{[1
]}

机构：

[1] Harvard Med Sch, Boston Childrens Hosp, Dept Neurol, Div Epilepsy & Clin Neurophysiol, Fegan 9,300 Longwood Ave, Boston, MA 02115 USA

[2] Univ Austral Chile, Fac Med, Inst Pediat, Valdivia, Chile

[3] Univ Chile, San Borja Arriaran Clin Hosp, Childrens Neuropsychiat Serv, Santiago, Chile

[4] Autonomous Univ Madrid, La Paz Univ Hosp, Dept Child Neurol, Madrid, Spain

[5] Oregon Hlth & Sci Univ, Doernbecher Childrens Hosp, Div Neurol, Portland, OR USA

[6] Phoenix Childrens Hosp, Phoenix, AZ USA

[7] Univ Colorado, Childrens Hosp Colorado, Dept Pediat, Sch Med, Aurora, CO USA

[8] Univ Barcelona, SJD Barcelona Childrens Hosp, Dept Child Neurol, Barcelona, Spain

[9] Univ Balearic Isl, Son Espases Univ Hosp, Dept Pediat, Pediat Neurol Unit, Palma De Mallorca, Spain

[10] Baylor Coll Med, Dept Pediat, Sect Neurol & Dev Neurosci, Houston, TX 77030 USA

[11] Univ Arizona, Coll Med, Dept Pediat, Phoenix, AZ USA

[12] Phoenix Childrens Hosp, Barrows Neurol Inst, Phoenix, AZ USA

[13] Univ Cincinnati, Cincinnati Childrens Hosp Med Ctr, Dept Pediat, Div Pediat Neurol,Coll Med, Cincinnati, OH USA

[14] Univ Virginia Hlth Syst, Dept Neurol & Pediat, Charlottesville, VA USA

[15] George Washington Univ, Sch Med & Hlth Sci, Childrens Natl Hosp, Ctr Neurosci, Washington, DC 20052 USA

[16] Med Coll Wisconsin, Childrens Hosp Wisconsin, Dept Pediat Neurol, Milwaukee, WI 53226 USA

[17] Northwestern Univ, Ruth D & Ken M Davee Pediat Neurocrit Care Progra, Feinberg Sch Med, Chicago, IL 60611 USA

[18] Univ British Columbia, British Columbia Childrens Hosp, Dept Pediat, Vancouver, BC, Canada

[19] Mayo Clin, Div Pediat Crit Care Med, Rochester, MN USA

[20] Mayo Clin, Dept Neurol, Rochester, MN USA

[21] Baylor Coll Med, Dept Pediat, Sect Pediat Crit Care Med, Houston, TX 77030 USA

[22] Northwestern Univ, Dept Pediat, Div Neurol & Epilepsy, Ann & Robert H Lurie Childrens Hosp Chicago,Feinb, Chicago, IL 60611 USA

[23] Duke Univ, Med Ctr, Div Pediat Neurol, Durham, NC USA

[24] Seattle Childrens Hosp, Dept Neurol, Div Child Neurol, Seattle, WA USA

[25] Ohio State Univ, Nationwide Childrens Hosp, Dept Pediat, Columbus, OH 43210 USA

[26] Univ Calgary, Alberta Childrens Hosp, Dept Pediat, Div Neurol, Calgary, AB, Canada

[27] Columbia Univ, Dept Neurol, Med Ctr, New York, NY USA

[28] Harvard Med Sch, Boston Childrens Hosp, Dept Anesthesiol Crit Care & Pain Med, Boston, MA 02115 USA

[29] Mayo Clin, Div Child & Adolescent Neurol, Sch Med, Rochester, MN USA

[30] Harvard Med Sch, Biostat & Res Design Ctr, Inst Ctr Clin & Translat Res, Boston Childrens Hosp,Dept Neurol, Boston, MA 02115 USA

[31] Harvard Med Sch, Biostat & Res Design Ctr, Boston Childrens Hosp, Inst Ctr Clin & Translat Res, Boston, MA 02115 USA

来源：

EPILEPSIA | 2021年 / 62卷 / 09期

关键词：

clinical neurology; epilepsy; outcome research; pediatric; status epilepticus; CONVULSIVE STATUS EPILEPTICUS; INTENSIVE-CARE; SEIZURE BURDEN; CHILDREN; CHILDHOOD; MORTALITY; ETIOLOGY; PREDICTORS; EPILEPSY; COHORT;

D O I：

10.1111/epi.16984

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective This study was undertaken to describe long-term clinical and developmental outcomes in pediatric refractory status epilepticus (RSE) and identify factors associated with new neurological deficits after RSE. Methods We performed retrospective analyses of prospectively collected observational data from June 2011 to March 2020 on pediatric patients with RSE. We analyzed clinical outcomes from at least 30 days after RSE and, in a subanalysis, we assessed developmental outcomes and evaluated risk factors in previously normally developed patients. Results Follow-up data on outcomes were available in 276 patients (56.5% males). The median (interquartile range [IQR]) follow-up duration was 1.6 (.9-2.7) years. The in-hospital mortality rate was 4% (16/403 patients), and 15 (5.4%) patients had died after hospital discharge. One hundred sixty-six (62.9%) patients had subsequent unprovoked seizures, and 44 (16.9%) patients had a repeated RSE episode. Among 116 patients with normal development before RSE, 42 of 107 (39.3%) patients with available data had new neurological deficits (cognitive, behavioral, or motor). Patients with new deficits had longer median (IQR) electroclinical RSE duration than patients without new deficits (10.3 [2.1-134.5] h vs. 4 [1.6-16] h, p = .011, adjusted odds ratio = 1.003, 95% confidence interval = 1.0008-1.0069, p = .027). The proportion of patients with an unfavorable functional outcome (Glasgow Outcome Scale-Extended score >= 4) was 22 of 90 (24.4%), and they were more likely to have received a continuous infusion. Significance About one third of patients without prior epilepsy developed recurrent unprovoked seizures after the RSE episode. In previously normally developing patients, 39% presented with new deficits during follow-up, with longer electroclinical RSE duration as a predictor.

引用

页码：2190 / 2204

页数：15

共 43 条

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