Association of systemic secondary brain insults and outcome in patients with convulsive status epilepticus: A post hoc study of a randomized controlled trial.
Aged
Brain
/ blood supply
Female
Fever
/ complications
Glasgow Outcome Scale
/ statistics & numerical data
Humans
Hypercapnia
/ complications
Hypotension
/ complications
Hypothermia, Induced
/ statistics & numerical data
Hypoxia
/ complications
Male
Middle Aged
Randomized Controlled Trials as Topic
/ statistics & numerical data
Respiration, Artificial
/ statistics & numerical data
Status Epilepticus
/ complications
Journal
Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060
Informations de publication
Date de publication:
03 11 2020
03 11 2020
Historique:
received:
14
01
2020
accepted:
04
06
2020
pubmed:
12
9
2020
medline:
15
12
2020
entrez:
11
9
2020
Statut:
ppublish
Résumé
To evaluate the association between systemic factors (mean arterial blood pressure, arterial partial pressures of carbon dioxide and oxygen, body temperature, natremia, and glycemia) on day 1 and neurologic outcomes 90 days after convulsive status epilepticus. This was a post hoc analysis of the Evaluation of Therapeutic Hypothermia in Convulsive Status Epilepticus in Adults in Intensive Care (HYBERNATUS) multicenter open-label controlled trial, which randomized 270 critically ill patients with convulsive status epilepticus requiring mechanical ventilation to therapeutic hypothermia (32°C-34°C for 24 hours) plus standard care or standard care alone between March 2011 and January 2015. The primary endpoint was a Glasgow Outcome Scale score of 5, defining a favorable outcome, 90 days after convulsive status epilepticus. The 172 men and 93 women had a median age of 57 years (45-68 years). Among them, 130 (49%) had a history of epilepsy, and 59 (29%) had a primary brain insult. Convulsive status epilepticus was refractory in 86 (32%) patients, and total seizure duration was 67 minutes (35-120 minutes). The 90-day outcome was unfavorable in 126 (48%) patients. In multivariate analysis, none of the systemic secondary brain insults were associated with outcome; achieving an unfavorable outcome was associated with age >65 years (odds ratio [OR] 2.17, 95% confidence interval [CI] 1.20-3.85; In our population, systemic secondary brain insults were not associated with outcome in critically ill patients with convulsive status epilepticus. NCT01359332.
Identifiants
pubmed: 32913029
pii: WNL.0000000000010726
doi: 10.1212/WNL.0000000000010726
doi:
Banques de données
ClinicalTrials.gov
['NCT01359332']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e2529-e2541Informations de copyright
© 2020 American Academy of Neurology.