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In-hospital mortality of generalized convulsive status epilepticus

A large US sample

From the Neurological Institute, University Hospitals Case Medical Center, Case School of Medicine, Cleveland, OH.

Address correspondence and reprint requests to Dr. Mohamad Z. Koubeissi, Department of Neurology, University Hospitals Case Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106-5040 mohamad.koubeissi{at}uhhospitals.org

Objective: To evaluate the in-hospital mortality associated with generalized convulsive status epilepticus (GCSE), and predictors of death in a large US cohort.

Methods: We identified our cohort from the National Inpatient Sample for the years 2000 through 2004 by searching the International Classification of Diseases, Ninth Revision, code for GCSE. We excluded patients with partial status epilepticus, and assessed whether associated diagnoses including brain tumors, CNS infections, stroke, hypoxic–ischemic brain injury, metabolic derangements, and respiratory failure predicted mortality. We used logistic regression models to identify predictors of death.

Results: Eleven thousand five hundred eighty patients were included in this analysis. The mean age of the patients was 39 ± 25.6 years, and the median duration of stay was 3 days. Male sex (53.4%) and white race (42.4%) were predominant. Overall in-hospital mortality was 399 in 11,580 (3.45%). Age was a significant predictor of death. Mortality tripled in those who received mechanical ventilation compared with those who did not (7.43% vs 2.22%, odds ratio [OR] 2.79, 95% CI 2.18 to 3.59). Other predictors of mortality included hypoxic–ischemic brain injury (OR 9.85, 95% CI 6.63 to 14.6), cerebrovascular diseases (OR 2.08, 95% CI 1.13 to 3.82), female sex (OR 1.34, 95% CI 1.04 to 1.73), and higher comorbidity index (OR 6.79, 95% CI 4.27 to 10.8).

Conclusion: Overall in-hospital mortality from generalized convulsive status epilepticus is low, but remarkably increases in those treated with mechanical ventilation. Other predictors of mortality include older age, female sex, hypoxic–ischemic brain injury, and higher comorbidity index.

Disclosure: The authors report no conflicts of interest.

Received January 6, 2007. Accepted in final form March 26, 2007.

This article has been cited by other articles:

				A. O. Rossetti, G. Logroscino, M. Z. Koubeissi, and A. Alshekhlee IN-HOSPITAL MORTALITY OF GENERALIZED CONVULSIVE STATUS EPILEPTICUS: A LARGE US SAMPLE Neurology, May 13, 2008; 70(20): 1939 - 1940. [Full Text] [PDF]

				Estimating Mortality Accurately in Generalized Convulsive Status Epilepticus Journal Watch Neurology, November 27, 2007; 2007(1127): 3 - 3. [Full Text]

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