Etiology and Outcome of Pediatric Status Epilepticus at Sawanpracharak Hospital
Keywords:
Status epilepticus, Children, Etiology, OutcomeAbstract
Objective : To study the etiology and outcome of children with status epilepticus (SE) and to evaluate the factors associated with unfavorable outcome.
Method : This is a retrospective analytic study. All patients with medical records age 1 month to 15 years old with SE admitted to Sawanpracharak Hospital, Nakhon Sawan, during 2011-2021 were studied. 122 patients were divided into 2 groups according to the outcome (favorable and unfavorable outcome). Multivariate logistic regression model was used to predict unfavorable outcome at discharge. A p-value of < 0.05 was considered statistically significant.
Results : 54.1% was boy and the median age was 3.2 years (IQR 1.1-6.3 years). 91 children (74.6%) had a favorable outcome, whereas 31 children (25.4%) had an unfavorable outcome. Overall mortality rate was 9%. Acute symptomatic (68.9%), remote symptomatic (16.4%), cryptogenic (10.7%) and progressive (4.1%) etiology were identified. Multivariate analysis revealed that unfavorable outcome was related to male (aOR, 4.49; 95%CI, 1.41-14.28; p=0.01), delayed development (aOR, 16.57; 95%CI, 4.12-66.74; p<0.01), SE duration > 5 hours (aOR, 6.58; 95%CI, 1.45-29.76; p=0.01), ≥ 4 anti-seizure medication (aOR, 10.24; 95%CI, 1.8-58.15; p=0.01).
Conclusions : Pediatric SE is highly associated with morbidity and mortality. The most common cause is acute symptomatic etiology. Children with pre-existing global delayed development or epilepsy should be aggressively treated. Early and effective treatment for termination of status epilepticus are the key factors to reduce morbidity and mortality.
Keywords : Status epilepticus, Children, Etiology, Outcome
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