Department of Neurology, Institute of Neurosciences, Queen Elizabeth University Hospital, Glasgow, G51 4TF, United Kingdom.
Department of Neurology, Institute of Neurosciences, Queen Elizabeth University Hospital, Glasgow, G51 4TF, United Kingdom; School of Medicine, Wolfson Medical School Building, University of Glasgow, Glasgow, G12 8QQ, United Kingdom.
Seizure. 2019 Feb;65:138-143. doi: 10.1016/j.seizure.2019.01.011. Epub 2019 Jan 14.
Our primary objective was to determine incidence of status epilepticus in adults admitted to 5 ITU settings in Glasgow over 18 years. We wanted to investigate if there are any change in causes and outcomes of SE over last decade. We also compared outcomes of De Novo statuts Epilpeticus (DNSE) and Stauts Epilepticus in patients with previous Epilepsy (SEPE).
The NHS GGC Research Ethics Committee gave permission for this study to continue without a full ethics submission. Between 2013 and 2016, coding records were searched across NHS Greater Glasgow and Clyde for adults over the age of 16 years admitted to an Intensive Care Facility in any of the hospitals in Glasgow.
633 cases were included in study. Cases were separated depending on whether there had been previous epilepsy (SEPE n = 214) or De Novo Status Epilepticus (DNSE, n = 419). Causes in both groups were listed, with 52% of those with DNSE having some contribution from substance misuse. In SEPE, this was felt to play a role in 33.7%. Duration of stay in both groups was similar, but the longest in-patient stays were in the DNSE group. Admission mortality was significantly higher in DNSE than in SEPE (13.8% versus 7.5%). This mortality risk was most closely associated with substance misuse in the group with DNSE.
DNSE has a worse prognosis than SEPE. A presentation with DNSE is sign of a system in peril, even where episodes are provoked by alcohol and or drug use. Such episodes should spark off a chain of multispecialty care in order to address this recurring and persisting public health catastrophe.
我们的主要目的是确定在格拉斯哥的 5 个 ICU 环境中，18 年来成年患者癫痫持续状态的发生率。我们想调查过去十年中癫痫持续状态的病因和结局是否有任何变化。我们还比较了既往癫痫患者新发癫痫持续状态（DNSE）和癫痫持续状态（SEPE）的结局。
NHS GGC 研究伦理委员会批准本研究在无需完整伦理申请的情况下继续进行。在 2013 年至 2016 年期间，在 NHS 大格拉斯哥和克莱德的编码记录中，搜索了年龄在 16 岁以上并在格拉斯哥任何一家医院的重症监护病房住院的成年人。
633 例患者纳入研究。根据是否有既往癫痫（SEPE n=214）或新发癫痫持续状态（DNSE，n=419），将病例分开。列出了两组的病因，DNSE 组有 52%的患者有物质滥用的一定影响，而 SEPE 组则认为这一比例为 33.7%。两组患者的住院时间相似，但 DNSE 组的住院时间最长。DNSE 组的入院死亡率明显高于 SEPE 组（13.8%对 7.5%）。这种死亡率风险与 DNSE 组的物质滥用密切相关。
DNSE 的预后比 SEPE 差。DNSE 的表现表明系统处于危险之中，即使发作是由酒精和/或药物使用引起的。这种发作应该引发一系列多学科护理，以解决这种反复出现的持续公共卫生灾难。
