Clinical findings, etiological factors, and prognosis markers in status epilepticus: a university hospital experience

ABSTRACT

Objective

To determine the factors affecting mortality and disability in status epilepticus (SE) and to evaluate the prediction ability of the Status Epilepticus Severity Score (STESS) for disability and mortality.

Materials and Method

The demographic and clinical characteristics, prognosis and prognosis predictors of 72 patients who were diagnosed with SE between 2013 and 2018 were retrospectively evaluated. The STESS was used to predict prognosis, and the modified Rankin scale (mRS) was used to determine the disability at discharge.

Results

The study population had a mean age of 45.4 ± 20.7, and it was found that mortality was 22.2% and acute symptomatic etiology played a 54.1% role in etiology. Advanced age, refractory SE or super-refractory SE, acute symptomatic etiology, and a history of epilepsy were related to mortality, symptomatic etiology (acute, progressive, remote), a history of hospitalization and epilepsy in intensive care or in other departments other than the neurology department were associated with disability. The sensitivity of STESS in predicting mortality was 100%, specificity was 69%, accuracy was 76.4%, positive predictive value (PPV) was 48.5%, and the negative predictive value (NPV) was 100%. The sensitivity of STESS in predicting mobilization during discharge was 55.6% with a 63.9% specificity and 59.7% accuracy, PPV was 60.6%, and NPV was 59%.

Conclusion

It was observed that STESS strongly predicts a good prognosis; however, it was not found to be useful in predicting motor disability during discharge. Thus, new studies should be conducted to predict and evaluate mobility in SE patients at discharge.

KEYWORDS:

• Epilepsy
• status epilepticus prognosis
• status epilepticus severity score
• modified Rankin scale
• disability

Acknowledgments

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author, [MFG]. The data are not publicly available due to privacy or ethical restrictions.

Authors’ contributions

MFG, FFE, and MFY: performed data collection. MFG, ÖFB: data analysis and interpretation. MFG: primary author. FFE: conceived the ideas. MFG, FFE, and ÖFB: provided revisions to the scientific consent of the manuscript. MFG, FFE, and MFY: principal investigators.

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.

Notes on contributors

Mehmet Fatih Göl

Mehmet Fatih Göl is a research associate in the Department of Neurology, Karadeniz Technical University School of Medicine. He is a Ph.D. student in clinical neurophysiology. He worked at the Erciyes University Faculty of Medicine and T. C. Ministry of Health Kayseri City Education and Research Hospital before. His interest is especially in clinical studies on epilepsy.

Füsun Ferda Erdoğan

Füsun Ferda Erdoğan is a professor in the Department of Neurology, Erciyes University Faculty of Medicine. She is a specialist in pediatric neurology and clinical genetics. She has focused mainly on genetic and clinical studies on epilepsy.

Mehmet Fatih Yetkin

Mehmet Fatih Yetkin is an associate professor in the Department of Neurology, Erciyes University Faculty of Medicine. She is a specialist in multiple sclerosis. She has focused mainly on clinical studies.

Ömer Faruk Bolattürk

Ömer Faruk Bolattürk is a neurologist in the Clinic of Neurology, T. C. Ministry of Health Kayseri City Education and Research Hospital. He has a special research interest in epilepsy and sleep disorders.