Abstract
Objectives Status epilepticus (SE) is a medical emergency with high mortality and morbidity. We aimed to determine the predictors of in-hospital mortality and increased disability in an Australian setting.
Methods We retrospectively reviewed medical records between Jan 2020 and Dec 2020 to identify patients diagnosed with status epilepticus. Data regarding in-hospital mortality, modified Rankin Score (mRS), medical history, management and outcomes were collected from the electronic medical records. Multivariable logistic regression was performed.
Results We identified 157 patients meeting the inclusion criteria. In-hospital mortality was 20.4%(32/157) and 40.8%(64/157) had an increase in their mRS. An aetiology was identified in 71.3%(112/157). Only 42.7%(67/157) received first-line benzodiazepine therapy.
After adjusting for confounders, age, presenting Glasgow Coma Score (GCS) and inpatient onset of SE were associated with in-hospital mortaltiy. For every 1 year increase in age, the odds of in-hospital mortality increased by 1.05 (95%CI 1.01–1.08). For every 1 point decrease in GCS, the odds of in-hospital mortality increased by 1.13 (95%CI 1.01–1.25). Inpatient onset had greater odds of in-hospital mortality (Odds ratio (OR) of 4.42, 95%CI 1.71–11.49). Age, GCS and inpatient onset of SE also independently predicted increase in mRS. Time to first, second and third-line therapy did not predict mortality or morbidity.
Conclusions Status epilepticus was associated with a high rate of mortality and morbidity. Less than one-quarter of patients had timely provision of first-line SE treatment. Age, initial GCS and inpatient onset of SE were the strongest predictors of in-hospital mortality and morbidity.
