Sato Kenichiro, Arai Noritoshi, Takeuchi Sousuke
Department of Neurology, Center Hospital of the National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan.
Department of Neurology, Center Hospital of the National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan.
J Clin Neurosci. 2020 May;75:128-133. doi: 10.1016/j.jocn.2020.03.004. Epub 2020 Mar 13.
To date, hospital length of stay (LOS) determinants for convulsive status epilepticus's (CSE) acute-phase treatment have not been sufficiently investigated, as opposed to those for status epilepticus's (SE) outcome predictors, such as status epilepticus severity score (STESS). Here, we aimed at assessing the significance of STESS in the LOS in patients with CSE. We retrospectively reviewed consecutive adult patients with CSE who were transported to the emergency department of our urban tertiary care hospital in Tokyo, Japan. The study period was from August 2010 to September 2015. The primary endpoint was the LOS of patients with CSE who were directly discharged after acute-phase treatment, and survival analysis for LOS until discharge was conducted. As a result, among 132 eligible patients with CSE admitted to our hospital, 96 (72.7%) were directly discharged with a median LOS of 10 days (IQR: 4-19 days). CSE patients with severe seizures, represented by higher STESS (≥3), had a significantly longer LOS after adjustments with multiple covariates (p = 0.016, in restricted mean survival time analysis). Additionally, prediction for the binomial longer/shorter LOS achieved better performance when STESS was incorporated into the prediction model. Our findings indicate that STESS can also be used as a rough predictor of longer LOS at index admission of patients with CSE.
迄今为止，与癫痫持续状态（SE）的预后预测因素（如癫痫持续状态严重程度评分（STESS））不同，惊厥性癫痫持续状态（CSE）急性期治疗的住院时间（LOS）决定因素尚未得到充分研究。在此，我们旨在评估STESS在CSE患者住院时间方面的意义。我们回顾性分析了连续转运至日本东京市区三级医疗中心急诊科的成年CSE患者。研究时间段为2010年8月至2015年9月。主要终点是急性期治疗后直接出院的CSE患者的住院时间，并对出院前的住院时间进行生存分析。结果，在我院收治的132例符合条件的CSE患者中，96例（72.7%）直接出院，中位住院时间为10天（四分位间距：4 - 19天）。以较高STESS（≥3）为代表的重度发作的CSE患者，在经多个协变量调整后，住院时间显著更长（在受限平均生存时间分析中，p = 0.016）。此外，当将STESS纳入预测模型时，对二项式长/短住院时间的预测表现更佳。我们的研究结果表明，STESS也可作为CSE患者首次入院时住院时间较长的粗略预测指标。
