Knake Susanne, Rochon Justine, Fleischer Sarah, Katsarou Niki, Back Tobias, Vescovi Mathias, Oertel Wolfgang H, Reis Janine, Hamer Hajo M, Rosenow Felix
Department of Neurology, Interdisciplinary Epilepsy Center, University Hospital Giessen and Marburg, Marburg, Germany.
Epilepsia. 2006 Dec;47(12):2020-6. doi: 10.1111/j.1528-1167.2006.00845.x.
The aim of this study was to determine the long-term case fatality of patients with a first episode of status epilepticus (SE group) of cerebrovascular etiology, as compared with that in acute stroke patients without SE (AS group).
Patients with SE who had been prospectively admitted to an epidemiologic study were retrospectively compared with a cohort of patients from the local stroke registry. The main outcome end point was overall survival. Survival curves were generated according to the Kaplan-Meier method and compared by using the log-rank test. An extended Cox model was used to examine the impact of patient group on the risk of death. Covariates considered potential confounders included age at diagnosis, sex, type of stroke, affected hemisphere, and localization of lesions.
Of 166 patients who entered the study, 93 patients were in the SE group, and 73 patients were in the AS group; 53 SE patients and 35 AS patients died during the study. Patient group (SE vs. AS) showed no significant impact on survival (p=0.0832) in univariate analysis. In contrast, the results from a multivariable analysis suggest that after 6 months, patients with SE were at about twice the risk of death as were patients with AS [hazard ratio of 2.12 with 95% confidence interval, 1.04-4.32, p=0.0392].
The occurrence of SE in patients with cerebrovascular disease indicates a high risk of death within 3 years. In contrast, the case fatality risk attributable to recurrent status or seizures is lower.
本研究旨在确定脑血管病因导致首次癫痫持续状态患者（癫痫持续状态组）的长期病死率，并与无癫痫持续状态的急性卒中患者（急性卒中组）进行比较。
将前瞻性纳入一项流行病学研究的癫痫持续状态患者与来自当地卒中登记处的一组患者进行回顾性比较。主要结局终点是总体生存率。根据Kaplan-Meier方法生成生存曲线，并使用对数秩检验进行比较。使用扩展Cox模型来检验患者组对死亡风险的影响。作为潜在混杂因素考虑的协变量包括诊断时的年龄、性别、卒中类型、受累半球和病变部位。
在166例进入研究的患者中，癫痫持续状态组有93例患者，急性卒中组有73例患者；研究期间，53例癫痫持续状态患者和35例急性卒中患者死亡。单因素分析中，患者组（癫痫持续状态组与急性卒中组）对生存率无显著影响（p=0.0832）。相比之下，多变量分析结果表明，6个月后，癫痫持续状态患者的死亡风险约为急性卒中患者的两倍[风险比为2.12，95%置信区间为1.04-4.32，p=0.0392]。
脑血管疾病患者发生癫痫持续状态表明3年内死亡风险较高。相比之下，由复发状态或癫痫发作导致的病死率风险较低。
