[P3-105] The complications and functional outcomes of non-convulsive status epilepticus in neurocritical care setting
[Introduction]
Nonconvulsive status epilepticus(NCSE) is poor prognostic factor in neurocritical care setting. However, the diagnosis and treatment of NCSE is still challenging especially in Japan because continuous EEG monitoring (cEEG) is unfamiliar, and its clinical impact is not sufficiently reported.
[Methodology]
We performed cEEG for 182 neurocritical care adult patients with coma or unexplained altered mental status from April 2013 to October 2015. We diagnosed patients with NCSE when the cEEG represented spatiotemporally evolving or fluctuating discharges. We devided patients into NCSE group and non-NCSE group, and assessed the incidence of pneumonia during hospitalization, and Glasgow Coma scale(GCS) score(3-8:poor, 9-15: not poor), modified ranking scale(0-4: not poor, 5-6: poor) and ability of complete oral intake at discharge.
[Results]
The mortality and inciedence of pneumonia of NCSE group and non-NCSE group were 17% vs 13%(p=0.26, OR:1.4583), and 48% vs 27%(p=0.0042 OR:2.4789) respectively. The poor mRS and poor GCS score at discharge was 46% vs 28%(p=0.0179, OR:2.149), and 28% vs 16%(p=0.0516, OR:2.0251). The capability of oral intake at discharge of NCSE group and non-NCSE group was 46% vs 60%(p=0.0612, OR:1.7517)
[Discussions]
Several previous reports suggested that NCSE relates to poor outcome. In this study, it is suggested that NCSE may relate to incidence of pneumonia and poor functional outcome. As limitation of this study, it is retroepective study and soft end points, so the result should be carefully assessed.
[Conclusions].
NCSE may be the risk factor of pneumonia and poor functional outcome. This is retrospective study, and further studies are needed.
Nonconvulsive status epilepticus(NCSE) is poor prognostic factor in neurocritical care setting. However, the diagnosis and treatment of NCSE is still challenging especially in Japan because continuous EEG monitoring (cEEG) is unfamiliar, and its clinical impact is not sufficiently reported.
[Methodology]
We performed cEEG for 182 neurocritical care adult patients with coma or unexplained altered mental status from April 2013 to October 2015. We diagnosed patients with NCSE when the cEEG represented spatiotemporally evolving or fluctuating discharges. We devided patients into NCSE group and non-NCSE group, and assessed the incidence of pneumonia during hospitalization, and Glasgow Coma scale(GCS) score(3-8:poor, 9-15: not poor), modified ranking scale(0-4: not poor, 5-6: poor) and ability of complete oral intake at discharge.
[Results]
The mortality and inciedence of pneumonia of NCSE group and non-NCSE group were 17% vs 13%(p=0.26, OR:1.4583), and 48% vs 27%(p=0.0042 OR:2.4789) respectively. The poor mRS and poor GCS score at discharge was 46% vs 28%(p=0.0179, OR:2.149), and 28% vs 16%(p=0.0516, OR:2.0251). The capability of oral intake at discharge of NCSE group and non-NCSE group was 46% vs 60%(p=0.0612, OR:1.7517)
[Discussions]
Several previous reports suggested that NCSE relates to poor outcome. In this study, it is suggested that NCSE may relate to incidence of pneumonia and poor functional outcome. As limitation of this study, it is retroepective study and soft end points, so the result should be carefully assessed.
[Conclusions].
NCSE may be the risk factor of pneumonia and poor functional outcome. This is retrospective study, and further studies are needed.