Short-Term Mortality After a First Episode of Status Epilepticus

Authors

  • Giancarlo Logroscino,

    1. Gertrude H. Sergievsky Center, New York, New York, U.S.A.
    2. School of Public Health at Columbia University, New York, New York, U.S.A.
    3. Divisione di Neurologia, Ospedale Miulli Acquaviva Bari, Italy
    4. Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, U.S.A.
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  • Dale C. Hesdorffer,

    1. Gertrude H. Sergievsky Center, New York, New York, U.S.A.
    2. Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, U.S.A.
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  • Gregory Cascino,

    1. Department of Neurology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, U.S.A.
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  • John F. Annegers,

    1. Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, U.S.A.
    2. School of Public Health, University of Texas, Houston, Texas, U.S.A.
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  • W. Allen Hauser

    Corresponding author
    1. Gertrude H. Sergievsky Center, New York, New York, U.S.A.
    2. Department of Neurology, Division of Epidemiology, New York, New York, U.S.A.
    3. School of Public Health at Columbia University, New York, New York, U.S.A.
    4. Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, U.S.A.
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Address correspondence and reprint requests to Dr. W. A. Hauser at G. H. Sergievsky Center, 630 West 168th Street, New York, New York 10032, U.S.A.

Abstract

Summary: Purpose: Studies evaluating short-term mortality among people who experience status epilepticus (SE) have produced conflicting results. Most studies are derived from clinical series with results affected by unspecified follow-up period and select referral of cases. This study was planned to evaluate short-term mortality after a first episode of SE.

Methods: We performed a population-based retrospective cohort study to determine the short-term mortality following a first episode of SE. Between January 1,1965 and December 31, 1984, we studied all first episodes of a febrile SE who received medical attention in Rochester, Minnesota. Cases were followed until death or end of the study (February 1996).

Results: Mortality within the first 30 days was 19% (38 deaths out of 201 incident SE). Thirty-four deaths (89%) occurred among those with non febrile acute symptomatic SE, while 4 deaths (11%) occurred among those with unprovoked SE. Within the acute symptomatic group, after adjusting for age, there was a decreased risk of death in women (RR = 0.4; 95% CI: 0.2–0.9). No effect of duration or seizure type was shown after adjusting for other risk factors.

Conclusions: One out of 5 subjects with SE died within the first 30 days. Short-term mortality is associated with the presence of an underlying acute etiology. Among acute symptomatic cases, women had a decreased risk of dying.

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