Abstracts

Rationale: Status epilepticus (SE) is a potentially life-threatening condition. The etiology, age, seizure type, and duration are associated with mortality rate in SE. How medical comorbidities and demographic characteristics influence mortality risks in SE is unknown. The purpose of this study was to investigate: 1) in-hospital mortality rates in patients admitted for SE 2) medical comorbidities, seizure types, and patient demographics associated with mortality. Methods: Using Nationwide Inpatient Sample (NIS) database, we examined medical comorbidities and patient characteristics in patients admitted with a diagnosis of SE (petit mal, grand mal or partialis continua) from 2008-2012 in the United States. Multivariate regression analysis was performed to identify predictive risk factors for in-hospital mortality. Results: A total of 125,091 patients were identified with SE (grand mal: 91.5%; petit mal: 0.6% and partialis continua: 7.9%). The mean age of patients with SE was 39 years +/- SD, with 53% male. Fifty-four percent of patients were Caucasian and sixty percent were admitted to teaching hospitals. The mean length of hospital stay was 5.5 +/- SD days. The in-hospital mortality in the cohort with admission diagnosis of SE was 2.7%. Multivariate regression analysis showed the following medical comorbidities were independent risk factors for in-hospital mortality: liver failure (adjusted odds ratio (AOR), 2.61), chronic kidney disease (AOR, 2.30), congestive heart failure (AOR, 2.05), diabetes mellitus (AOR, 1.22). Demographics predictors for in-hospital mortality include: age > 60 years (AOR, 3.32), Native American (AOR, 1.73), female (AOR, 1.23). Additional predictors of mortality include grand mal seizures (AOR, 2.47), teaching hospitals (AOR, 1.62), and smoking (AOR, 1.21). Other ethnicities (African- American, Hispanic or Asian), hypertension, lung disease, obesity, alcohol abuse, cocaine use, history of benign brain tumor or central nervous system infection did not carry a higher risk for mortality. Conclusions: This study demonstrated that specific medical comorbidities (congestive heart failure, diabetes, chronic liver and kidney disease) and demographic factors were significant predictors for mortality in patients with SE. Compared to previous studies, the mortality rate in this study was lower and this may be related to younger mean age and preexisting diagnosis of epilepsy. The current study represents the largest sample of patients with SE examined to date and sets a foundation for future prospective studies to examine whether aggressive treatment of medical comorbidities will alter mortality rates in SE.