Rossetti A O, Logroscino G, Liaudet L, Ruffieux C, Ribordy V, Schaller M D, Despland P A, Oddo M
Service de Neurologie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Neurology. 2007 Jul 17;69(3):255-60. doi: 10.1212/01.wnl.0000265819.36639.e0.
Prognosis of status epilepticus (SE) depends on its cause, but there is uncertainty as to whether SE represents an independent outcome predictor for a given etiology. Cerebral anoxia is a relatively homogenous severe encephalopathy. Postanoxic SE is associated to a nearly 100% mortality in this setting; however, it is still unclear whether this is a severity marker of the underlying encephalopathy, or an independent factor influencing outcome. The goal of this study was to assess if postanoxic SE is independently associated with mortality after cerebral anoxia.
This was a retrospective observation of consecutive comatose survivors of cardiac arrest, including subjects treated with hypothermia. On the subgroup with EEG recordings in the first hospitalization days, univariate and multivariate analyses were applied to potential determinants of in-hospital mortality, and included the following variables: age, gender, type and length of cardiac arrest, occurrence of circulatory shock, presence of therapeutic hypothermia, and electrographic SE.
Out of 166 postanoxic patients, 107 (64%) had an EEG (median latency from admission, 2 days); in this group, therapeutic hypothermia was administered in 59%. Death occurred in 71 (67%) patients. Postanoxic SE was associated with mortality regardless of type of acute cardiac rhythm and administration of hypothermic treatment.
In this hospital-based cohort, postanoxic status epilepticus (SE) seems to be independently related to death in cardiac arrest survivors, suggesting that SE might determine a bad prognosis for a given etiology. Confirmation of these results in a prospective assessment is needed.
癫痫持续状态（SE）的预后取决于其病因，但对于SE是否代表特定病因的独立预后预测因素尚存在不确定性。脑缺氧是一种相对同质的严重脑病。在这种情况下，缺氧后SE的死亡率接近100%；然而，目前仍不清楚这是潜在脑病的严重程度标志物，还是影响预后的独立因素。本研究的目的是评估缺氧后SE是否与脑缺氧后的死亡率独立相关。
这是一项对心脏骤停连续昏迷幸存者的回顾性观察研究，包括接受低温治疗的患者。对于首次住院期间有脑电图记录的亚组，对院内死亡的潜在决定因素进行单因素和多因素分析，包括以下变量：年龄、性别、心脏骤停的类型和持续时间、循环性休克的发生、治疗性低温的使用以及脑电图显示的SE。
166例缺氧后患者中，107例（64%）进行了脑电图检查（入院后中位延迟时间为2天）；在该组中，59%的患者接受了治疗性低温治疗。71例（67%）患者死亡。无论急性心律类型和低温治疗的使用情况如何，缺氧后SE均与死亡率相关。
在这个基于医院的队列中，缺氧后癫痫持续状态（SE）似乎与心脏骤停幸存者的死亡独立相关，这表明SE可能决定了特定病因的不良预后。需要在前瞻性评估中证实这些结果。
