Risk Factors Associated with Death in In-Hospital Pediatric Convulsive Status Epilepticus

被引:40
|
作者
Loddenkemper, Tobias [1 ,2 ]
Syed, Tanvir U. [3 ]
Ramgopal, Sriram [1 ,2 ]
Gulati, Deepak [3 ]
Thanaviratananich, Sikawat [3 ]
Kothare, Sanjeev V. [1 ,2 ]
Alshekhlee, Amer [4 ]
Koubeissi, Mohamad Z. [3 ,5 ]
机构
[1] Childrens Hosp Boston, Dept Neurol, Boston, MA USA
[2] Harvard Univ, Sch Med, Boston, MA USA
[3] Case Western Reserve Univ & Univ Hosp, Dept Neurol, Cleveland, OH USA
[4] St Louis Univ, Dept Neurol, St Louis, MO 63103 USA
[5] George Washington Univ, Dept Neurol, Washington, DC USA
来源
PLOS ONE | 2012年 / 7卷 / 10期
基金
美国国家卫生研究院;
关键词
REFRACTORY STATUS EPILEPTICUS; CONTINUOUS MIDAZOLAM; CLINICAL-FEATURES; TERM MORTALITY; UNITED-STATES; 1ST EPISODE; CHILDREN; EPILEPSY; CHILDHOOD; EFFICACY;
D O I
10.1371/journal.pone.0047474
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Objective: To evaluate in-patient mortality and predictors of death associated with convulsive status epilepticus (SE) in a large, multi-center, pediatric cohort. Patients and Methods: We identified our cohort from the KID Inpatient Database for the years 1997, 2000, 2003 and 2006. We queried the database for convulsive SE, associated diagnoses, and for inpatient death. Univariate logistic testing was used to screen for potential risk factors. These risk factors were then entered into a stepwise backwards conditional multivariable logistic regression procedure. P-values less than 0.05 were taken as significant. Results: We identified 12,365 (5,541 female) patients with convulsive SE aged 0-20 years (mean age 6.2 years, standard deviation 5.5 years, median 5 years) among 14,965,571 pediatric inpatients (0.08%). Of these, 117 died while in the hospital (0.9%). The most frequent additional admission ICD-9 code diagnoses in addition to SE were cerebral palsy, pneumonia, and respiratory failure. Independent risk factors for death in patients with SE, assessed by multivariate calculation, included near drowning (Odds ratio [OR] 43.2; Confidence Interval [CI] 4.4-426.8), hemorrhagic shock (OR 17.83; CI 6.5-49.1), sepsis (OR 10.14; CI 4.0-25.6), massive aspiration (OR 9.1; CI 1.8-47), mechanical ventilation >96 hours (OR9; 5.6-14.6), transfusion (OR 8.25; CI 4.3-15.8), structural brain lesion (OR7.0; CI 3.1-16), hypoglycemia (OR5.8; CI 1.75-19.2), sepsis with liver failure (OR 14.4; CI 5-41.9), and admission in December (OR3.4; CI 1.6-4.1). African American ethnicity (OR 0.4; CI 0.2-0.8) was associated with a decreased risk of death in SE. Conclusion: Pediatric convulsive SE occurs in up to 0.08% of pediatric inpatient admissions with a mortality of up to 1%. There appear to be several risk factors that can predict mortality. These may warrant additional monitoring and aggressive management.
引用
收藏
页数:11
相关论文
共 50 条
  • [1] Factors associated with treatment delays in pediatric refractory convulsive status epilepticus
    Fernandez, I. Sanchez
    Gainza-Lein, M.
    Abend, N. S.
    Anderson, A. E.
    Arya, R.
    Brenton, J. N.
    Carpenter, J. L.
    Chapman, K. E.
    Clark, J.
    Gaillard, W. D.
    Glauser, T. A.
    Goldstein, J. L.
    Goodkin, H. P.
    Helseth, A. R.
    Jackson, M. C.
    Kapur, K.
    Lai, Y. -C.
    McDonough, T. L.
    Mikati, M. A.
    Nayak, A.
    Peariso, K.
    Riviello, J. J., Jr.
    Tasker, R. C.
    Tchapyjnikov, D.
    Topjian, A. A.
    Wainwright, M. S.
    Wilfong, A.
    Williams, K.
    Loddenkemper, T.
    [J]. NEUROLOGY, 2018, 90 (19) : E1692 - E1701
  • [2] Status epilepticus increases the odds of in-hospital death
    Trevathan, E
    Fitzgerald, R
    Hailu, A
    Rurangirwa, L
    Wang, DL
    [J]. NEUROLOGY, 2002, 58 (07) : A336 - A336
  • [3] In-hospital mortality of generalized convulsive status epilepticus - A large US sample
    Koubeissi, Mohamad
    Alshekhlee, Amer
    [J]. NEUROLOGY, 2007, 69 (09) : 886 - 893
  • [4] Refractory Convulsive Status Epilepticus in Children: Etiology, Associated Risk Factors and Outcome
    Barzegar, Mohammad
    Mahdavi, Mohammad
    Behbehani, Afshin Galegolab
    Tabrizi, Aidin
    [J]. IRANIAN JOURNAL OF CHILD NEUROLOGY, 2015, 9 (04) : 24 - 31
  • [5] Pharmacotherapy for Pediatric Convulsive Status Epilepticus
    Avantika Singh
    Coral M. Stredny
    Tobias Loddenkemper
    [J]. CNS Drugs, 2020, 34 : 47 - 63
  • [6] Pharmacotherapy for Pediatric Convulsive Status Epilepticus
    Singh, Avantika
    Stredny, Coral M.
    Loddenkemper, Tobias
    [J]. CNS DRUGS, 2020, 34 (01) : 47 - 63
  • [7] Treatment of pediatric convulsive status epilepticus
    Becker, Lena-Luise
    Gratopp, Alexander
    Prager, Christine
    Elger, Christian E.
    Kaindl, Angela M.
    [J]. FRONTIERS IN NEUROLOGY, 2023, 14
  • [8] In-hospital mortality of generalized convulsive status epilepticus: Analysis of a large US sample
    Koubeissi, Mohamad
    Alshekhlee, Amer
    [J]. ANNALS OF NEUROLOGY, 2007, 62 (05) : 541 - 541
  • [9] In-hospital mortality of generalized convulsive status epilepticus: A large us sample - Reply
    Koubeissi, Mohamad Z.
    Alshekhlee, Amer
    [J]. NEUROLOGY, 2008, 70 (20) : 1939 - 1940
  • [10] The etiology and risk factors of convulsive status epilepticus in pediatric patients of tertiary center in Saudi Arabia
    Alyoubi, Reem A.
    Aljaafari, Danah T.
    Basheikh, Mazen A.
    Al-Yahyawi, Naseem Y.
    Bakry, Maria A.
    BenHli, Nojoud M.
    Sindi, Ghaidaa J.
    Alhainiah, Maha H.
    Alateeq, Maram M.
    Nasser, Jomanah A.
    Al-Hayani, Majed M.
    [J]. NEUROSCIENCES, 2021, 26 (01) : 26 - 30