Hay Alison, Bellomo Rinaldo, Pilcher David, Jackson Graeme, Kaukonen Kirsi-Majia, Bailey Michael
Austin Hospital, Heidelberg, Melbourne, Victoria, Australia.
Austin Hospital, Heidelberg, Melbourne, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; The Australian and New Zealand Intensive Care Research Centre, Monash University School of Publish Health and Preventive Medicine, Melbourne, Australia.
J Crit Care. 2016 Aug;34:146-53. doi: 10.1016/j.jcrc.2016.03.003. Epub 2016 Mar 9.
Status epilepticus (SE) is a neurological emergency and may lead to Intensive Care Unit (ICU) admission. However, little is known about the characteristics and outcome of patients with the ICU admission diagnosis of SE.
We performed a retrospective study of patients admitted to ICU with the primary admission diagnosis of SE as recorded in the Australian and New Zealand Intensive Care Society (ANZICS) Adult Patient Database over more than a decade. We examined the ICU and population incidence, physiological and demographic features of such SE patients; compared ventilated and non-ventilated SE patients and assessed their mortality.
From 2000-2013, 12,926 patients (1.2% of all ICU admissions) were admitted to ANZ ICUs with SE as the main admission diagnosis. Over the study period, the ICU prevalence (0.93 vs 1.13%), population incidence (30 vs 61 per million population), ICU length of stay (1.45 vs 1.77 days) and the rate of discharge to a rehabilitation facility (2.3 vs 7.1%) of SE increased (P < .0001). In contrast, the use of mechanical ventilation (56.6 vs 47.2%), hospital length of stay (6.64 vs 5.81 days), ICU (2.6 vs 0.75%) and hospital (8.2 vs 4%) mortality decreased (P < .0001). Overall hospital mortality was 613 (4.7%) with 219 (1.7%) patients dying in ICU. Mortality was associated with advancing age, multiple co-morbidities, lower GCS on admission and higher APACHE III scores. From 2000 to 2013 ICU mortality decreased from 2.6% to 0.75%.
Over a 14-year period in ANZ, there have been major changes in the features, management and outcome of patients admitted to ICU with the primary admission diagnosis of SE such that their ICU mortality is now <1%.
癫痫持续状态（SE）是一种神经科急症，可能导致患者入住重症监护病房（ICU）。然而，对于因SE入住ICU的患者的特征和转归了解甚少。
我们对澳大利亚和新西兰重症监护学会（ANZICS）成人患者数据库中记录的因SE作为主要入院诊断而入住ICU的患者进行了一项回顾性研究，研究时间跨度超过十年。我们调查了此类SE患者的ICU发病率和总体发病率、生理和人口统计学特征；比较了接受机械通气和未接受机械通气的SE患者，并评估了他们的死亡率。
2000年至2013年期间，12926例患者（占所有ICU入院患者的1.2%）因SE作为主要入院诊断入住ANZ的ICU。在研究期间，SE患者的ICU患病率（0.93%对1.13%）、总体发病率（每百万人口30例对61例）、ICU住院时间（1.45天对1.77天）以及转至康复机构的出院率（2.3%对7.1%）均有所上升（P < 0.0001）。相比之下，机械通气的使用比例（56.6%对47.2%）、住院时间（6.64天对5.81天）、ICU死亡率（2.6%对0.75%）和医院死亡率（8.2%对4%）均有所下降（P < 0.0001）。总体医院死亡率为613例（4.7%），其中219例（1.7%）患者在ICU死亡。死亡率与年龄增长、多种合并症、入院时较低的格拉斯哥昏迷评分（GCS）以及较高的急性生理和慢性健康状况评分系统（APACHE III）得分相关。2000年至2013年期间，ICU死亡率从2.6%降至0.75%。
在ANZ地区的14年期间，因SE作为主要入院诊断入住ICU的患者在特征、管理和转归方面发生了重大变化，目前其ICU死亡率<1%。
