Document Detail


Status epilepticus: an independent outcome predictor after cerebral anoxia.
MedLine Citation:
PMID:  17636063     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Prognosis of status epilepticus (SE) depends on its cause, but there is uncertainty as to whether SE represents an independent outcome predictor for a given etiology. Cerebral anoxia is a relatively homogenous severe encephalopathy. Postanoxic SE is associated to a nearly 100% mortality in this setting; however, it is still unclear whether this is a severity marker of the underlying encephalopathy, or an independent factor influencing outcome. The goal of this study was to assess if postanoxic SE is independently associated with mortality after cerebral anoxia. METHODS: This was a retrospective observation of consecutive comatose survivors of cardiac arrest, including subjects treated with hypothermia. On the subgroup with EEG recordings in the first hospitalization days, univariate and multivariate analyses were applied to potential determinants of in-hospital mortality, and included the following variables: age, gender, type and length of cardiac arrest, occurrence of circulatory shock, presence of therapeutic hypothermia, and electrographic SE. RESULTS: Out of 166 postanoxic patients, 107 (64%) had an EEG (median latency from admission, 2 days); in this group, therapeutic hypothermia was administered in 59%. Death occurred in 71 (67%) patients. Postanoxic SE was associated with mortality regardless of type of acute cardiac rhythm and administration of hypothermic treatment. CONCLUSION: In this hospital-based cohort, postanoxic status epilepticus (SE) seems to be independently related to death in cardiac arrest survivors, suggesting that SE might determine a bad prognosis for a given etiology. Confirmation of these results in a prospective assessment is needed.
Authors:
A O Rossetti; G Logroscino; L Liaudet; C Ruffieux; V Ribordy; M D Schaller; P A Despland; M Oddo
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Neurology     Volume:  69     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-07-19     Completed Date:  2007-08-03     Revised Date:  2008-06-12    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  255-60     Citation Subset:  AIM; IM    
Affiliation:
Service de Neurologie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. andrea.rossetti@chuv.ch
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cohort Studies
Female
Heart Arrest / complications,  epidemiology,  physiopathology
Humans
Hypoxia, Brain / epidemiology*,  etiology,  physiopathology
Male
Middle Aged
Predictive Value of Tests
Retrospective Studies
Risk Factors
Status Epilepticus / epidemiology*,  etiology,  physiopathology
Treatment Outcome
Comments/Corrections
Comment In:
Neurology. 2008 Apr 8;70(15):1295; author reply 1295-6   [PMID:  18391164 ]
Neurology. 2008 May 20;70(21):2015-6; author reply 2015-6   [PMID:  18490626 ]

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