Universität zu Köln

Malter, M. P., Nass, R. D., Kaluschke, T., Fink, G. R., Burghaus, L. and Dohmen, C. (2017). New onset status epilepticus in older patients: Clinical characteristics and outcome. Seizure, 51. S. 114 - 121. LONDON: W B SAUNDERS CO LTD. ISSN 1532-2688

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Abstract

Purpose: We here evaluated (1) the differential characteristics of status epilepticus (SE) in older (>= 60 years) compared to younger adults (18-59 years). In particular, we were interested in (2) the proportion and characteristics of new onset SE in patients with no history of epilepsy (NOSE) in older compared to younger adults, and (3) predictive parameters for clinical outcome in older subjects with NOSE. Methods: We performed a monocentric retrospective analysis of all adult patients (>= 18 years) admitted with SE to our tertiary care centre over a period of 10 years (2006-2015) to evaluate clinical characteristics and short-time outcome at discharge. Results: One-hundred-thirty-five patients with SE were included in the study. Mean age at onset was 64 years (range 21-90), eighty-seven of the patients (64%) were older than 60 years. In 76 patients (56%), SE occurred as NOSE, sixty-seven percent of them were aged >= 60 years. There was no age-dependent predominance for NOSE. NOSE was not a relevant outcome predictor, especially regarding age-related subgroups. Older patients with NOSE had less frequently general tonic clonic SE (GTCSE; p = 0.001) and were more often female (p = 0.01). Regarding outcome parameters and risk factors in older patients with NOSE, unfavourable outcome was associated with infections during in-hospital treatment (0.04), extended stay in ICU (p = 0.001), and generally in hospital (p < 0.001). Conclusion: In our cohort, older patients represented the predominant subgroup in patients with SE. Older patients suffered more often from non-convulsive semiology and had a less favourable short-time outcome. NOSE was not a predictive outcome parameter in older patients. Data suggest that avoiding infections should have a priority because higher infection rates were associated with unfavourable outcome. (C) 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Malter, M. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nass, R. D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kaluschke, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, G. R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Burghaus, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dohmen, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-215974
DOI:	10.1016/j.seizure.2017.08.006
Journal or Publication Title:	Seizure
Volume:	51
Page Range:	S. 114 - 121
Date:	2017
Publisher:	W B SAUNDERS CO LTD
Place of Publication:	LONDON
ISSN:	1532-2688
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language REFRACTORY STATUS EPILEPTICUS; SEVERITY SCORE; CASE-FATALITY; ADULTS; EPIDEMIOLOGY; PROGNOSIS; STESS; EMSE; MORTALITY; CHILDREN Multiple languages Clinical Neurology; Neurosciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/21597