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Association Between Treatment Progression, Disease Refractoriness, and Burden of Illness Among Hospitalized Patients With Status Epilepticus

By Currents Editor posted 04-21-2021 10:43

  

JAMA Neurology (04/05/21) DOI: 10.1001/jamaneurol.2021.0520

Guterman, Elan L.; Betjemann, John P.; Aimetti, Alex; et al.

https://jamanetwork.com/journals/jamaneurology/article-abstract/2777805

Highly refractory status epilepticus (SE) is associated with increased hospitalization costs and worse outcomes, according to new research. The cross-sectional study evaluated 43,988 hospitalizations related to SE from 2016 through 2018 in the United States. Patients were categorized by the administration of antiseizure drugs given while hospitalized: low refractoriness (treatment with none or one intravenous antiseizure drug), moderate refractoriness (more than one I.V. antiseizure drug), and high refractoriness (treatment with one or more I.V. antiseizure drug, more than one I.V. anesthetic, and intensive care unit admission). Of the 14,694 admissions, 33.4% were for low refractory SE, 23.1% were for moderate refractory SE, and 43.5% were for highly refractory SE. Overall in-hospital mortality was 11.2%, with rates ranging from 4.6% for low refractory SE to 18.9% for highly refractory SE. Similarly, patients with high refractory SE also had longer median hospital length of stays and higher hospital costs. The findings highlight the large burden that SE places on patients and the U.S. health system, and suggest that interventions that keep SE from advancing to a more refractory state may be able to improve outcomes and reduce associated costs.

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