Refractory status epilepticus in adults admitted to ITU in Glasgow 1995-2013 a longitudinal audit highlighting the need for action for provoked and unprovoked status epilepticus

Abbasi, H. and Leach, J. P. (2019) Refractory status epilepticus in adults admitted to ITU in Glasgow 1995-2013 a longitudinal audit highlighting the need for action for provoked and unprovoked status epilepticus. Seizure, 65, pp. 138-143. (doi: 10.1016/j.seizure.2019.01.011) (PMID:30690407)

Abstract

Purpose: Our primary objective was to determine incidence of status epilepticus in adults admitted to 5 ITU settings in Glasgow over 18 years. We wanted to investigate if there are any change in causes and outcomes of SE over last decade. We also compared outcomes of De Novo statuts Epilpeticus (DNSE) and Stauts Epilepticus in patients with previous Epilepsy (SEPE). Methods: The NHS GGC Research Ethics Committee gave permission for this study to continue without a full ethics submission. Between 2013 and 2016, coding records were searched across NHS Greater Glasgow and Clyde for adults over the age of 16 years admitted to an Intensive Care Facility in any of the hospitals in Glasgow. Results: 633 cases were included in study. Cases were separated depending on whether there had been previous epilepsy (SEPE n = 214) or De Novo Status Epilepticus (DNSE, n = 419). Causes in both groups were listed, with 52% of those with DNSE having some contribution from substance misuse. In SEPE, this was felt to play a role in 33.7%. Duration of stay in both groups was similar, but the longest in-patient stays were in the DNSE group. Admission mortality was significantly higher in DNSE than in SEPE (13.8% versus 7.5%). This mortality risk was most closely associated with substance misuse in the group with DNSE. Conclusion: DNSE has a worse prognosis than SEPE. A presentation with DNSE is sign of a system in peril, even where episodes are provoked by alcohol and or drug use. Such episodes should spark off a chain of multispecialty care in order to address this recurring and persisting public health catastrophe.

• Item Type: Articles
• Keywords: Admission, alcohol, convulsion, DNSE, disability, epilepsy, ITU, mortality, prognosis, provoked, RSE, refractory status epilepticus, SE, SEPE, status epilepticus, unprovoked.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Abbasi, Hina and Leach, Dr John Paul
• Authors: Abbasi, H., and Leach, J. P.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Seizure
• Publisher: Elsevier
• ISSN: 1059-1311
• ISSN (Online): 1532-2688
• Published Online: 14 January 2019
• Copyright Holders: Copyright © 2019 British Epilepsy Association
• First Published: First published in Seizure 65:138-143
• Publisher Policy: Reproduced in accordance with the publisher copyright policy