Tsai M-H, Chuang Y-C, Chang H-W, Chang W-N, Lai S-L, Huang C-R, Tsai N-W, Wang H-C, Lin Y-J, Lu C-H
Department of Neurology, Chang Gung Memorial Hospital, #123 Ta Pei Road, Niao Sung Hsiang, Kaohsiung County, Taiwan.
QJM. 2009 Jan;102(1):57-62. doi: 10.1093/qjmed/hcn149. Epub 2008 Nov 16.
About 50% of status epilepticus (SE) patients have no previous history of epilepsy, but often have worse outcome. The aim of this study was to evaluate potential risk factors that are predictive of poor outcome in non-selected de novo status epilepticus patients.
Eighty-three adult status epilepticus patients without a pre-existing history of epilepsy that were admitted to hospital for treatment were enrolled in this 11-year retrospective study. The baseline prognostic variables were analyzed based on stepwise logistic regression analysis after a minimum of one-and-half years of follow-up.
The overall fatality rate was 55.4% (46/83) during the study period. Poor outcome was associated with older age, presence of refractory status epilepticus, potential fatal etiologies, lower GCS score at presentation and level of consciousness on admission. The results of stepwise logistic regression demonstrated that age on presentation and potential fatal etiologies were independently associated with presence of poor outcome, and any increase in age by 1 year increases poor outcome by 7.5%.
The outcome for those with de novo status epilepticus is poor and this poor outcome may be attributed to the older age at onset and the potential fatal underlying conditions such as infection and metabolic derangement.
约50%的癫痫持续状态（SE）患者既往无癫痫病史，但预后往往较差。本研究旨在评估非选择性初发性癫痫持续状态患者预后不良的潜在危险因素。
本项为期11年的回顾性研究纳入了83例因癫痫持续状态入院治疗且既往无癫痫病史的成年患者。在至少随访一年半后，基于逐步逻辑回归分析对基线预后变量进行分析。
研究期间总死亡率为55.4%（46/83）。预后不良与年龄较大、存在难治性癫痫持续状态、潜在致命病因、入院时格拉斯哥昏迷评分较低以及意识水平有关。逐步逻辑回归结果表明，入院时年龄和潜在致命病因与预后不良独立相关，年龄每增加1岁，预后不良的风险增加7.5%。
初发性癫痫持续状态患者预后较差，这种不良预后可能归因于发病时年龄较大以及潜在致命的基础疾病，如感染和代谢紊乱。
