Appropriate drug treatment for status epilepticus does not influence its prognosis

TitreAppropriate drug treatment for status epilepticus does not influence its prognosis
Publication TypeConference Paper
Year of Publication2012
AuthorsRossetti, AO, Alvarez, V, Januel, JM, Burnand, B
Conference Name137th Annual Meeting of the American Neurological Association
Conference LocationBoston, United-States, October 7-9, 2012
ISBN Number1531-8249
Accession Numberserval:BIB_396F17AC1502
Abstract

Objective: Status epilepticus (SE) prognosis, is mostly
related to non-modifiable factors (especially age, etiology),
but the specific role of treatment appropriateness (TA) has
not been investigated.
Methods: In a prospective cohort with incident SE
(excluding postanoxic), TA was defined, after recent European
recommendations, in terms of drug dosage (630%
deviation) and sequence. Outcome at hospital discharge was
categorized into mortality, new handicap, or return to
baseline.
Results: Among 225 adults, treatment was inappropriate
in 37%. In univariate analyses, age, etiology, SE severity and
comorbidity, but not TA, were significantly related to outcome.
Etiology (95% CI 4.3-82.8) and SE severity (95%
CI 1.2-2.4) were independent predictors of mortality, and
of lack of return to baseline conditions (etiology: 95% CI
3.9-14.0; SE severity: 95% CI 1.4-2.2). Moreover, TA did
not improve outcome prediction in the corresponding ROC
curves.
Conclusions: This large analysis suggests that TA plays a
negligible prognostic role in SE, probably reflecting the outstanding
importance of the biological background. Awaiting
treatment trials in SE, it appears questionable to apply further
resources in refining treatment protocols involving
existing compounds; rather, new therapeutic approaches
should be identified and tested.

Notes

oai:serval.unil.ch:BIB_396F17AC1502

WOS ID (UT)

Publié

Citation Key / SERVAL ID3976

                         

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