Determinants of Mortality in Status Epilepticus

Authors

  • Alan R. Towne,

    Corresponding author
    1. Department of Neurology, Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia, U.S.A.
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  • John M. Pellock,

    1. Department of Neurology, Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia, U.S.A.
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  • Daijin Ko,

    1. Department of Biostatistics, Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia, U.S.A.
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  • Robert J. DeLorenzo

    1. Department of Neurology, Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia, U.S.A.
    2. Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia, U.S.A.
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Address correspondence and reprint requests to Dr. A. R. Towne at Department of Neurology, Medical College of Virginia, P.O. Box 599, MCV Station, Richmond, VA 23298, U.S.A.

Abstract

Summary: Using univariate and multivariate regression analysis, we studied seizure duration, seizure type, age, etiologies, other clinical features, and mortality among 253 adults with status epilepticus (SE) admitted to the Medical College of Virginia. Cerebral vascular disease and discontinuation of antiepileptic drugs (AEDs) were the most prominent causes of SE, each accounting for ∼22% of all patients in the series. The other principle etiologies were alcohol withdrawal, idiopathic, anoxia, metabolic disorders, hemorrhage, infection, tumor, drug overdose, and trauma. When the patients were divided into two groups, the group with SE lasting < 1 h had a lower mortality as compared with seizure duration ≥ 1 h. Low mortality rates were noted in alcohol and AED discontinuation etiologies. Anoxia and increasing age were significantly correlated with higher mortality. The mortality rates of partial and generalized SE were not significantly different. Race and sex did not affect mortality significantly. Our findings represent the first multivariate analysis of predictive indicators of mortality in SE and demonstrate that specific factors influence mortality rate in SE.

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