Jayalakshmi Sita, Vooturi Sudhindra, Sahu Sambit, Yada Praveen Kumar, Mohandas Surath
Department of Neurology, Krishna Institute of Medical Sciences, 1-8-31/1, Minister Road, Secunderabad 500003, Telangana, India.
Department of Neurology, Krishna Institute of Medical Sciences, 1-8-31/1, Minister Road, Secunderabad 500003, Telangana, India.
J Clin Neurosci. 2016 Apr;26:89-94. doi: 10.1016/j.jocn.2015.06.032. Epub 2016 Jan 25.
We aimed to evaluate the determinants of outcome in new onset refractory status epilepticus (SE). A retrospective analysis of patients with new onset SE admitted between May 2005 and October 2013 was performed. Regression analysis was used to determine factors that affect progression of new onset SE to refractory status epilepticus (RSE) and mortality. Among 114 patients with new onset SE, 52 patients progressed to RSE. Sixty seven (58.7%) were men. New onset RSE patients were younger than new onset SE patients (mean 35.9 ± standard deviation18.2 versus 28.7 ± 20.2 years; p=0.050). Cryptogenic aetiology was the most significant determinant of progression of new onset SE to RSE (Exp [β]=5.68; p=0.001). The overall mortality in the entire group was 23.7%, significantly higher in new onset RSE group (40.4% versus 9.7%; p<0.0001). New onset RSE patients with symptomatic and cryptogenic etiology did not differ for clinical characteristics and outcome. Acidosis was the strongest predictor of mortality in the entire cohort (Exp [β]=8.72; p=0.005). Nearly half of the patients with new onset SE progressed to RSE. While cryptogenic aetiology determined progression of new onset SE to RSE, acidosis was associated with mortality. The outcome was similar between symptomatic and cryptogenic new onset RSE.
我们旨在评估新发性难治性癫痫持续状态（SE）的预后决定因素。对2005年5月至2013年10月期间收治的新发性SE患者进行了回顾性分析。采用回归分析来确定影响新发性SE进展为难治性癫痫持续状态（RSE）和死亡率的因素。在114例新发性SE患者中，52例进展为RSE。67例（58.7%）为男性。新发性RSE患者比新发性SE患者年轻（平均35.9±标准差18.2岁对28.7±20.2岁；p=0.050）。隐源性病因是新发性SE进展为RSE的最显著决定因素（Exp[β]=5.68；p=0.001）。整个组的总死亡率为23.7%，新发性RSE组显著更高（40.4%对9.7%；p<0.0001）。有症状和隐源性病因的新发性RSE患者在临床特征和预后方面无差异。酸中毒是整个队列中死亡率的最强预测因素（Exp[β]=8.72；p=0.005）。近一半的新发性SE患者进展为RSE。虽然隐源性病因决定了新发性SE进展为RSE，但酸中毒与死亡率相关。有症状和隐源性新发性RSE的预后相似。
