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使用连续脑电图监测对重症监护病房非惊厥性癫痫发作的评估:与死亡率相关变量的调查。

An assessment of nonconvulsive seizures in the intensive care unit using continuous EEG monitoring: an investigation of variables associated with mortality.

作者信息

Young G B, Jordan K G, Doig G S

机构信息

Dept. of Clinical Neurological Sciences, Victoria Hospital, London, Ontario, Canada.

出版信息

Neurology. 1996 Jul;47(1):83-9. doi: 10.1212/wnl.47.1.83.

Abstract

Of 49 patients with nonconvulsive seizures studied with continuous EEG monitoring, the overall mortality was 33% (16/49). Of the 23 patients with nonconvulsive status epilepticus (NCSE), 13 died (mortality 57%). Individual variables significantly associated with mortality were age, presence of NCSE, seizure duration, hospital and NICU length of stay, and delay to diagnosis and etiology (acute illness versus remote symptomatic). With multivariate logistic regression, only seizure duration (p = 0.0057, OR = 1.131/hour) and delay to diagnosis (p = 0.0351, OR = 1.039/hour) were associated with increased mortality. Acute symptomatic cases could not be adequately classified as either absence, simple, or complex partial status epilepticus when the impairment of consciousness arose form the initial illness. Current classifications of status epilepticus are inadequate for such cases.

摘要

在49例接受连续脑电图监测的非惊厥性癫痫患者中,总死亡率为33%(16/49)。在23例非惊厥性癫痫持续状态(NCSE)患者中,13例死亡(死亡率57%)。与死亡率显著相关的个体变量包括年龄、NCSE的存在、发作持续时间、住院和新生儿重症监护病房(NICU)住院时间,以及诊断和病因延迟(急性疾病与远隔症状性)。通过多因素逻辑回归分析,只有发作持续时间(p = 0.0057,比值比[OR]=1.131/小时)和诊断延迟(p = 0.0351,OR = 1.039/小时)与死亡率增加相关。当意识障碍源于初始疾病时,急性症状性病例不能充分归类为失神、简单或复杂部分性癫痫持续状态。目前癫痫持续状态的分类对于此类病例并不适用。

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