Auckland City Hospital, Te Whatu Ora Te Toka Tumai, Grafton, Auckland, New Zealand; Centre for Brain Research, University of Auckland, Auckland, New Zealand.
Auckland City Hospital, Te Whatu Ora Te Toka Tumai, Grafton, Auckland, New Zealand.
Seizure. 2024 Oct;121:17-22. doi: 10.1016/j.seizure.2024.07.015. Epub 2024 Jul 21.
To document the 2-year mortality and seizure recurrence rate of a prospective cohort of patients identified with status epilepticus (SE).
Patients presenting to any hospital in the Auckland region between April 6 2015, and April 5 2016, with a seizure lasting 10 min or longer were identified. Follow up was at 2 years post index SE episode via telephone calls and detailed review of clinical notes.
We identified 367 patients with SE over the course of one year. 335/367 (91.3 %) were successfully followed up at the 2-year mark. Two-year all-cause mortality was 50/335 (14.9 %), and 49/267 (18.4 %) when febrile SE was excluded. Two-year seizure recurrence was 197/335 (58.8 %). On univariate analyses, children (preschoolers 2 to < 5 years and children 5 to < 15 years), Asian ethnicity, SE duration <30 mins and acute (febrile) aetiology were associated with lower mortality, while older age >60 and progressive causes were associated with higher mortality on both univariate and multivariate analyses. Age < 2 years and acute aetiology were associated with lower seizure recurrence, while non convulsive status epilepticus (NCSE) with coma and a history of epilepsy were associated with higher seizure recurrence. On multivariate analyses, a history of epilepsy, as well as having both acute and remote causes were associated with higher seizure recurrence.
All-cause mortality in both the paediatric and adult populations at 2 years was lower than most previous reports. Older age, SE duration ≥30 mins and progressive aetiologies were associated with the highest 2-year mortality, while febrile SE had the lowest mortality. A history of epilepsy, NCSE with coma, and having both acute and remote causes were associated with higher seizure recurrence at 2 years. Future studies should focus on functional measures of outcome and long-term quality of life.
记录前瞻性癫痫持续状态（SE）患者队列的 2 年死亡率和癫痫发作复发率。
本研究于 2015 年 4 月 6 日至 2016 年 4 月 5 日期间，在奥克兰地区的任何一家医院，识别出持续 10 分钟或更长时间的癫痫发作患者。通过电话和详细审查临床记录，在 SE 指数发作后 2 年进行随访。
在一年的时间里，我们共发现 367 例 SE 患者。335/367（91.3%）患者在 2 年随访点成功随访。全因死亡率为 50/335（14.9%），排除热性 SE 后为 49/267（18.4%）。2 年癫痫发作复发率为 197/335（58.8%）。单因素分析显示，儿童（2-<5 岁和 5-<15 岁）、亚洲人种、SE 持续时间<30 分钟和急性（热性）病因与较低的死亡率相关，而年龄>60 岁和进行性病因与单因素和多因素分析中的较高死亡率相关。年龄<2 岁和急性病因与较低的癫痫发作复发率相关，而非惊厥性癫痫持续状态（NCSE）伴昏迷和癫痫病史与较高的癫痫发作复发率相关。多因素分析显示，癫痫病史以及急性和慢性病因均与较高的癫痫发作复发率相关。
在儿童和成人人群中，2 年的全因死亡率均低于大多数既往报道。年龄较大、SE 持续时间≥30 分钟和进行性病因与最高的 2 年死亡率相关，而热性 SE 的死亡率最低。癫痫病史、NCSE 伴昏迷和具有急性和慢性病因与 2 年时较高的癫痫发作复发率相关。未来的研究应集中于功能预后和长期生活质量的评估。
