Affiliations 

  • 1 Auckland City Hospital, Te Whatu Ora Te Toka Tumai, Grafton, Auckland, New Zealand; Centre for Brain Research, University of Auckland, Auckland, New Zealand
  • 2 Auckland City Hospital, Te Whatu Ora Te Toka Tumai, Grafton, Auckland, New Zealand
  • 3 Auckland City Hospital, Te Whatu Ora Te Toka Tumai, Grafton, Auckland, New Zealand; Sheffield Teaching Hospitals, NHS Foundation Trust, Sheffield, United Kingdom
  • 4 Auckland City Hospital, Te Whatu Ora Te Toka Tumai, Grafton, Auckland, New Zealand; Pantai-Gleneagles Hospital, Penang and Sungai Petani, Kedah, Malaysia
  • 5 Auckland City Hospital, Te Whatu Ora Te Toka Tumai, Grafton, Auckland, New Zealand; Western General Hospital, Edinburgh, United Kingdom
  • 6 Department of Surgery and Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand; Starship Children's Hospital, Te Whatu Ora Te Toka Tumai, Grafton, Auckland, New Zealand
  • 7 North Shore and Waitākere Emergency Departments, Te Whatu Ora Waitematā, Auckland, New Zealand
  • 8 Middlemore Hospital, Te Whatu Ora Counties Manukau, Auckland, New Zealand
  • 9 Auckland City Hospital, Te Whatu Ora Te Toka Tumai, Grafton, Auckland, New Zealand; Centre for Brain Research, University of Auckland, Auckland, New Zealand. Electronic address: pbergin@adhb.govt.nz
Seizure, 2024 Jul 21;121:17-22.
PMID: 39053336 DOI: 10.1016/j.seizure.2024.07.015

Abstract

PURPOSE: To document the 2-year mortality and seizure recurrence rate of a prospective cohort of patients identified with status epilepticus (SE).

METHODS: Patients presenting to any hospital in the Auckland region between April 6 2015, and April 5 2016, with a seizure lasting 10 min or longer were identified. Follow up was at 2 years post index SE episode via telephone calls and detailed review of clinical notes.

RESULTS: We identified 367 patients with SE over the course of one year. 335/367 (91.3 %) were successfully followed up at the 2-year mark. Two-year all-cause mortality was 50/335 (14.9 %), and 49/267 (18.4 %) when febrile SE was excluded. Two-year seizure recurrence was 197/335 (58.8 %). On univariate analyses, children (preschoolers 2 to < 5 years and children 5 to < 15 years), Asian ethnicity, SE duration <30 mins and acute (febrile) aetiology were associated with lower mortality, while older age >60 and progressive causes were associated with higher mortality on both univariate and multivariate analyses. Age < 2 years and acute aetiology were associated with lower seizure recurrence, while non convulsive status epilepticus (NCSE) with coma and a history of epilepsy were associated with higher seizure recurrence. On multivariate analyses, a history of epilepsy, as well as having both acute and remote causes were associated with higher seizure recurrence.

CONCLUSIONS: All-cause mortality in both the paediatric and adult populations at 2 years was lower than most previous reports. Older age, SE duration ≥30 mins and progressive aetiologies were associated with the highest 2-year mortality, while febrile SE had the lowest mortality. A history of epilepsy, NCSE with coma, and having both acute and remote causes were associated with higher seizure recurrence at 2 years. Future studies should focus on functional measures of outcome and long-term quality of life.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.