Single Center Outcomes of Status Epilepticus at a Paediatric Intensive Care Unit

Samir Shah, Namrata Shah, Robert Johnson, Alina West, Narayan Prasad

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Status epilepticus (SE) is a frequent admission diagnosis to paediatric intensive care units (PICUs) and is associated with variable outcomes. We have audited our experience of patients presenting in SE at a Canadian PICU to determine unfavorable outcome variables. Methods: Charts of patients <18 years of age presenting in SE to a tertiary care PICU over a 10-year period were audited. Data were analyzed at three care-points: transport, the emergency department (ED) and the PICU. Patient outcome before PICU discharge was categorized as "favorable" for return to pre-status functioning level or "unfavorable" for new deficit/death. Student's t-test and the Kruskal-Wallis test were used for analysis of normal and skewed continuous variables, respectively, and either Chi-square test or Fisher's exact test for categorical variables. Results: 189 patients (54% males) were identified with a median age of 1.9 years. Idiopathic SE had the highest incidence; infectious/vascular etiologies were associated with more unfavorable outcomes. Progression to refractory SE in the ED had a higher incidence of death (p<0.05). Patients with an unfavorable outcome had a higher incidence of apnea during transport (p=0.01), longer hospital stays (p<0.05), need for therapeutic coma (p=0.01), longer duration of therapeutic coma (p<0.05), need for mechanical ventilation (p<0.05), and recurrent or refractory seizures during inpatient stay (p<0.05). Multivariate analysis of unfavorable outcomes of patients in SE presenting to the PICU included renal failure, cerebral edema, apnea during transport, refractory seizures, and recurrent seizures. Conclusions: Refractory seizures in children presenting with SE are associated with worsened outcomes in the PICU.

Original languageEnglish (US)
Pages (from-to)105-112
Number of pages8
JournalCanadian Journal of Neurological Sciences
Volume43
Issue number1
DOIs
StatePublished - Jun 5 2015

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Pediatric Intensive Care Units
Status Epilepticus
Seizures
Apnea
Coma
Hospital Emergency Service
Incidence
Point-of-Care Systems
Brain Edema
Tertiary Healthcare
Chi-Square Distribution
Artificial Respiration
Renal Insufficiency
Blood Vessels
Inpatients
Length of Stay
Multivariate Analysis
Students
Therapeutics

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

Single Center Outcomes of Status Epilepticus at a Paediatric Intensive Care Unit. / Shah, Samir; Shah, Namrata; Johnson, Robert; West, Alina; Prasad, Narayan.

In: Canadian Journal of Neurological Sciences, Vol. 43, No. 1, 05.06.2015, p. 105-112.

Research output: Contribution to journalArticle

Shah, Samir ; Shah, Namrata ; Johnson, Robert ; West, Alina ; Prasad, Narayan. / Single Center Outcomes of Status Epilepticus at a Paediatric Intensive Care Unit. In: Canadian Journal of Neurological Sciences. 2015 ; Vol. 43, No. 1. pp. 105-112.
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