Use of newer antiepileptic drugs and prognosis in adults with status epilepticus: Comparison between 2009 and 2017. (31st May 2018)

• Record Type: Journal Article
• Authors: Fatuzzo, Daniela; Novy, Jan; Rossetti, Andrea O.
• Is Part Of: Epilepsia. Volume 59:issue 7(2018)
• Page Start: e98
• Page End: e102
• Publication Date: 2018-05-31
• Subjects: anticonvulsant -- functional outcome -- mortality -- treatment; Epilepsy -- Periodicals; 616.853
• DOI: 10.1111/epi.14434
• Languages: English
• ISSNs: 0013-9580

Abstract

Summary: It is unclear whether the outcome of status epilepticus (SE), a neurological emergency associated with high mortality and morbidity, has changed over the past decade. We investigated the difference in prognosis (mortality, functional status at discharge) after adult SE episodes in a large registry between 2 time points (the years 2009 and 2017), exploring factors potentially associated with outcome, with particular attention to use of newer antiepileptic drugs (AEDs). Newer AEDs were more often prescribed in SE episodes in 2017 (80.2% vs 38.5%, P < .001); this independently correlated with year of observation, SE refractoriness, nonconvulsive SE forms, and number of AEDs. We observed a higher proportion of deterioration from baseline conditions in 2017 (67.7% vs 42.3%, P < .001), which was independently associated with, among other variables, use of newer AEDs (odds ratio = 2.91, 95% confidence interval = 1.13‐7.48), whereas mortality seemed more stable over time (16.1% vs 6.3%, P = .08) without any relationship with newer AEDs. These observations suggest that newer AEDs might affect functional status but not mortality. Further investigations are necessary to improve therapeutic strategies, which currently rely on weak evidence.