Clinical and Electroencephalographic Predictors of Seizures and Status Epilepticus in 12,450 Critically Ill Adults: A Retrospective Cohort Study
Published on: May 12, 2023
Using a large database of hospitalized adults undergoing continuous electroencephalogram (cEEG) monitoring, researchers identified specific predictors of status epilepticus (SE) and seizures. Ordinal outcomes for the first 72 hours of cEEG were no seizures; isolated seizures without SE; or SE, with or without isolated seizures. The composite groups were isolated seizures or SE (AnySz) and no seizure or isolated seizures. Among the 12,450 patients (mean age 60 years), 9.8% (1,226) had AnySz and 3.5% (429) had SE. Cardiac arrest, clinical seizures before cEEG, brain neoplasms, lateralized periodic discharges (LPDs), brief potentially ictal rhythmic discharges, and generalized periodic discharges (GPDs) were identified as independent factors associated with SE. These factors, plus lateralized rhythmic delta activity, were also linked to AnySz. Cardiac arrest, clinical seizures, GPDs, and LPDs all substantially raised the risk of SE over isolated seizures. “These findings,” write the researchers, “could be used to tailor cEEG monitoring for critically ill patients.”