Rivero Rodríguez Dannys, Pluck Graham
Eugenio Espejo Hospital, Department of Neurology, Gran Colombia Ave., PO Box 17-07-9515, Quito, Ecuador.
Universidad San Francisco de Quito, Institute of Neurosciences, Av. Diego de Robles & Vía Interoceánica, PO BOX: 17-09-01, Quito, Ecuador.
eNeurologicalSci. 2021 Dec 24;26:100389. doi: 10.1016/j.ensci.2021.100389. eCollection 2022 Mar.
There are differences in epidemiology, etiology, and outcome in status epilepticus (SE) between developing and developed countries, which limits generalizability. We evaluated factors related to outcome at 3 months in SE patients in a developing country- Ecuador.
Retrospective analysis of a prospectively collected dataset of patients treated for SE at a single hospital over 4 years, recording on 107 patients and 109 episodes, including clinical, demographic, and prognosis assessments.
Hospital mortality was 33%, and 38% at 3 months. Glasgow Coma Scale score pretreatment ≤12 (odds ratio = 7.7), Charlson Index of comorbidities ≥3 (odds ratio = 5.6) and brain lesion (odds ratio = 6.4) predicted high disability. History of epilepsy was associated with favorable outcome in general, and showed a positive impact on survival rates (odds ratio = 0.3), while Glasgow Coma Scale scores pretreatment ≤12 (odds ratio = 4.1) and refractory SE (odds ratio = 2.1) were associated with reduced survival rates. Acute symptomatic etiology was the most common cause of SE (58%). Etiologies with structural brain lesion showed a significantly lower survival rate (Log ranks = 0.04 and 0.003) compared to other groups.
Mortality rate at 3 months for SE patients was high. Glasgow Coma Scale, Charlson Index, and brain lesions were associated with unfavorable outcome, including mortality. Overall, the results were similar to those reported in more developed countries, but some differences, including overall higher mortality, prevalence of nonconvulsive SE, and lack of association of age with outcome were evident.
发展中国家和发达国家在癫痫持续状态（SE）的流行病学、病因及预后方面存在差异，这限制了研究结果的普遍性。我们评估了发展中国家厄瓜多尔SE患者3个月时与预后相关的因素。
对一家医院4年期间前瞻性收集的SE治疗患者数据集进行回顾性分析，记录了107例患者和109次发作，包括临床、人口统计学和预后评估。
医院死亡率为33%，3个月时为38%。格拉斯哥昏迷量表（Glasgow Coma Scale）预处理评分≤12（比值比=7.7）、合并症查尔森指数（Charlson Index）≥3（比值比=5.6）和脑损伤（比值比=6.4）预示着高残疾率。癫痫病史总体上与良好预后相关，并对生存率有积极影响（比值比=0.3），而格拉斯哥昏迷量表预处理评分≤12（比值比=4.1）和难治性SE（比值比=2.1）与生存率降低相关。急性症状性病因是SE最常见的原因（58%）。与其他组相比，伴有结构性脑损伤的病因生存率显著降低（对数秩检验=0.04和0.003）。
SE患者3个月时的死亡率很高。格拉斯哥昏迷量表、查尔森指数和脑损伤与不良预后相关，包括死亡率。总体而言，结果与较发达国家报告的结果相似，但也存在一些差异，包括总体死亡率较高、非惊厥性SE的患病率以及年龄与预后缺乏相关性。
