Early predictors of status epilepticus-associated mortality and morbidity in children.


BACKGROUND Early predictors of status epilepticus (SE)-associated mortality and morbidity have not been systematically studied in children, considerably impeding the identification of patients at risk. OBJECTIVES To determine reliable early predictors of SE-associated mortality and morbidity and identify the etiology of SE-associated sequelae in Japanese children. METHODS We conducted a prospective multicenter study of clinical findings and initial laboratory data acquired at SE onset, and assessed outcomes at the last follow-up examination. In-hospital death during the acute period and neurological sequelae were classified as poor outcomes. RESULTS Of the 201 children who experienced their first SE episode, 16 exhibited poor outcome that was most commonly associated with acute encephalopathy. Univariate analysis revealed that the following were associated with poor outcomes: young age (⩽24 months); seizure duration >90 min; seizure intractability (failure of the second anticonvulsive drug); biphasic seizures; abnormal blood glucose levels (<61 or >250 mg/dL); serum aspartate aminotransferase (AST) ⩾56 U/L; and C-reactive protein (CRP) levels >2.00 mg/dL. Multivariate analysis revealed that young age, seizure intractability, abnormal blood glucose levels, and elevated AST and CRP levels were statistically significant. CONCLUSIONS Young age and seizure intractability were highly predictive of poor outcomes in pediatric SE. Moreover, abnormal blood glucose levels and elevated AST and CRP levels were predictors that might be closely associated with the etiology, especially acute encephalopathy and severe bacterial infection (sepsis and meningitis) in Japanese children.

DOI: 10.1016/j.braindev.2014.08.004

Cite this paper

@article{Maegaki2015EarlyPO, title={Early predictors of status epilepticus-associated mortality and morbidity in children.}, author={Yoshihiro Maegaki and Youichi Kurozawa and Akiko Tamasaki and Masami Togawa and Akiko Tamura and Masato Hirao and Akihisa Nagao and Takayuki Kouda and Takayoshi Okada and Hiroshi Hayashibara and Yuichiro Harada and Makoto Urushibara and Chitose Sugiura and Hitoshi Sejima and Yuji Tanaka and Hiroko Matsuda-Ohtahara and Takeshi Kasai and Kazuko Kishi and Syunsaku Kaji and Mitsuo Toyoshima and Susumu Kanzaki and Kousaku Ohno}, journal={Brain & development}, year={2015}, volume={37 5}, pages={478-86} }