Farjoud Kouhanjani Mohsen, Shafie'ei Mohammad, Hashemi Bita, Farazdaghi Mohsen, Asadi-Pooya Ali A
Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
Epilepsy Behav. 2025 Mar;164:110259. doi: 10.1016/j.yebeh.2024.110259. Epub 2025 Jan 16.
As a debilitating and severe repercussion, the clinical and economic impact of Status epilepticus (SE) has not been thoroughly explored in various regions around the world, especially those with limited resources. Therefore, we aimed to identify the predictors of mortality and healthcare costs associated with SE in one tertiary care center with limited resources.
This retrospective single-center cohort study, carried out at Namazi Hospital, Shiraz, Iran, included 130 SE cases from March 21, 2021, to March 20, 2022. Patient data were extracted from medical records, including demographics, clinical presentations, hospital course, treatment modalities, and costs. Multivariable regression models were used to identify factors associated with mortality and hospital stay costs.
Patients were aged 1 month to 92 years (mean 20.36 years, median 7), with a male predominance of 59.23 %. Pre-existing epilepsy was found to be associated with lower mortality (p < 0.05), while cardiovascular complications (p < 0.05) and cerebrovascular disease (p < 0.001) were significantly associated with increased mortality risks. In addition, Intensive Care Unit (ICU) admission, necessitated by complex treatment regimens, was linked to significantly higher healthcare costs (p < 0.001). Older age and the use of sedatives were also associated with higher costs, while psychiatric disorders were linked to lower costs.
SE imposes a substantial clinical and economic burden in resource-limited settings, as limited availability of ICU beds is common. Thus, screening SE cases based on clinical characteristics (e.g., comorbidities) is paramount. Therefore, targeted strategies are essential for optimizing care and reducing costs.
癫痫持续状态（SE）作为一种使人衰弱的严重后果，其临床和经济影响在世界各地区，尤其是资源有限的地区，尚未得到充分研究。因此，我们旨在确定一家资源有限的三级医疗中心中与SE相关的死亡率和医疗费用的预测因素。
这项回顾性单中心队列研究在伊朗设拉子的纳马齐医院进行，纳入了2021年3月21日至2022年3月20日期间的130例SE病例。从医疗记录中提取患者数据，包括人口统计学、临床表现、住院过程、治疗方式和费用。使用多变量回归模型来确定与死亡率和住院费用相关的因素。
患者年龄从1个月至92岁（平均20.36岁，中位数7岁），男性占比59.23%。发现既往有癫痫与较低的死亡率相关（p<0.05），而心血管并发症（p<0.05）和脑血管疾病（p<0.001）与死亡风险增加显著相关。此外，复杂治疗方案所需的重症监护病房（ICU）入院与显著更高的医疗费用相关（p<0.001）。年龄较大和使用镇静剂也与较高费用相关，而精神障碍与较低费用相关。
在资源有限的环境中，SE会带来巨大的临床和经济负担，因为ICU床位供应有限很常见。因此，根据临床特征（如合并症）筛查SE病例至关重要。因此，有针对性的策略对于优化护理和降低成本至关重要。
