Etiology, clinical characteristics and in-hospital mortality of status epilepticus: Single center experience

Abstract

Objective: Status epilepticus (SE) is a serious neurological emergency that can has high morbidity and mortality rates and requires prompt diagnosis and treatment. There are different etiologies and the prognosis varies multifactorially. The aim of this study was to reveal the etiological causes, clinical features and mortality rates of patients diagnosed with SE at our center.Methods: The records of 234 patients with a diagnosis of SE over the age of 18 who were followed up and treated at our center between 01.01.2015-01.01.2022 were evaluated retrospectively. Using the hospital information operating system database, we identified people hospitalized with an International Classification of Diseases 10th Revision code G41 for SE as the primary diagnosis. Demographic information, clinical characteristics, and discharge results were obtained from medical records.Results: One hundred-twenty (51.3%) female and 114 (48.7%) male patients were evaluated. The top 3 most common etiologic causes were: discontinuation of anti-seizure treatments without advice (n=82), cerebrovascular events (n=50), and meningitis or encephalitis (n=39). Motor seizures were detected in 183 (78.2%) patients, and non-motor seizures were detected in 51 (21.8%) patients. Seizures were suppressed by first-line treatment in 24 patients and by second -line treatments in 135 patients. Seventy-five patients whose seizures could not be suppressed were accepted as refractory SE and 9 died. The mean age of all patients was 55, and 63 of the patients died.Conclusion: In this study, clinical and demographic features, the etiological causes and in the hospital mortality rates of SE followed in a single center in the Turkish population were determined. The most common causes of patients diagnosed with SE were discontinuation of anti-seizure treatments without our recommendation, cerebrovascular diseases and central nervous system infections, respectively. In our center, no relationship was found between age and mortality. The in-hospital mortality rate was 3.9% for all patients (n=234) and 12% for patients with refractory SE (n=75).