Shire Development LLC, a Takeda company, Lexington, MA, United States of America.
YOLARX Consultants Inc., Montreal, Quebec, Canada.
Epilepsy Behav. 2020 Nov;112:107459. doi: 10.1016/j.yebeh.2020.107459. Epub 2020 Sep 29.
Convulsive status epilepticus (CSE) is a life-threatening neurologic emergency, which is defined by the International League Against Epilepsy (ILAE) as bilateral tonic-clonic seizure activity lasting longer than 5 min, while absence status epilepticus (SE) and focal SE are specified as exceeding 10 min. Epidemiological evidence on SE is currently lacking, and the incidence is not well-known, especially in light of changes in the ILAE criteria for SE. The objectives of this systematic literature review were to describe the epidemiology of SE in the US population and the associated burden of illness.
A systematic review, including literature and pragmatic searches, was conducted. Literature searches were performed using MEDLINE, Embase, BIOSIS, and Web of Science electronic databases from inception to February 2019. Pragmatic searches of the gray literature were carried out using Google, Google Scholar, conference proceedings, and ClinicalTrials.gov to identify additional sources. Only US-based studies or multinational studies reporting US data of interest were included.
In total, 69 sources were identified. The incidence of all SE in patients of all ages in the USA ranged from 18.3 to 41 per 100,000 people per year. Incidence of all-age CSE rose from 3.5 (1979) to 12.5 (2010) per 100,000 people per year. Status epilepticus incidence followed a bimodal (U-shaped) distribution, with the highest estimates in the first years of life (0-4 years) and after 60 years. Mortality associated with SE varied from 21% over 30 days to 31.2% over 10 years. For CSE, two studies reported similar in-hospital mortalities (9.2% and 10.7%). Median healthcare costs related to SE admission were approximately US$14,500 per adult (17-45 years) and US$8000 per child (0-16 years).
There is a lack of recent data on the epidemiology and healthcare burden associated with SE. Reports of SE incidence in the USA are highly variable and predate the 2015 ILAE definition of SE. However, the available data suggest a high burden of illness.
癫痫持续状态（CSE）是一种危及生命的神经系统急症，国际抗癫痫联盟（ILAE）将其定义为双侧强直阵挛性发作活动持续超过 5 分钟，而失神持续状态（SE）和局灶性 SE 则被指定为超过 10 分钟。目前缺乏关于 SE 的流行病学证据，发病率也不为人知，尤其是考虑到 ILAE 对 SE 的定义发生了变化。本系统文献综述的目的是描述美国人群中 SE 的流行病学情况及其相关疾病负担。
进行了系统文献综述，包括文献和实用搜索。文献搜索使用 MEDLINE、Embase、BIOSIS 和 Web of Science 电子数据库从开始到 2019 年 2 月进行。实用搜索使用 Google、Google Scholar、会议记录和 ClinicalTrials.gov 进行了灰色文献搜索，以确定其他来源。仅纳入基于美国的研究或报告美国相关数据的多国研究。
共确定了 69 个来源。美国所有年龄段患者的所有 SE 发病率范围为每年每 100000 人 18.3 至 41 例。所有年龄段 CSE 的发病率从 1979 年的 3.5（每 100000 人每年）上升到 2010 年的 12.5。癫痫持续状态的发病率呈双峰（U 形）分布，最高估计值出现在生命的最初几年（0-4 岁）和 60 岁以后。SE 相关的死亡率从 30 天内的 21%到 10 年内的 31.2%不等。对于 CSE，两项研究报告了相似的住院死亡率（9.2%和 10.7%）。与 SE 入院相关的医疗保健费用中位数约为每位成人（17-45 岁）14500 美元，每位儿童（0-16 岁）8000 美元。
目前缺乏有关 SE 流行病学和与 SE 相关的医疗保健负担的最新数据。美国 SE 发病率的报告差异很大，并且早于 2015 年 ILAE 对 SE 的定义。然而，现有数据表明疾病负担很高。
