Status Epilepticus
Conditions
Keywords
Status epilepticus, Gender differences in neurology, Gender differences in Status epilepticus, Antiseizure medication
Brief summary
Sex-specific differences in neurological emergencies such as Status epilepticus (SE) remain understudied despite growing recognition of gender disparities in medicine. This study aimes to investigate sex-related differences in etiology, diagnostics, treatment, and outcomes among patients with SE. The investigators conducted a retrospective analysis of 779 patients treated with SE at Marburg University Hospital between 2011 and 2023.
Interventions
None listed
Sponsors
University Hospital Marburg
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* patients who were treated at Marburg University Hospital (UKGM Marburg) between January 2011 to March 2023 with diagnosis of SE
Exclusion criteria
* children
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Age at SE Onset | Baseline (day 1) | Age in years at the time of SE onset as documented in the medical record. |
| Diagnosis of SE Subtype | During hospital stay, maximum 30 days | Classification of SE subtype based on clinical presentation and EEG findings, documented in the medical record. Categories include absence SE, generalized tonic-clonic SE, SE with complex focal seizure. Aggregation method / Unit of measure: Number and percentage of participants (n, %) |
| Semiology: Focal vs. Generalized | During hospital stay, maximum 30 days | Seizure semiology classified as focal or generalized based on clinical presentation and EEG documentation in the medical record Categories: focal; generalized Aggregation method / Unit of measure: Number and percentage of participants (n, %) |
| Non-convulsive SE | During hospital stay, maximum 30 days | Occurrence of non-convulsive SE, classified according to clinical and EEG findings as documented in the medical record. Categories: convulsive; non-convulsive Aggregation method / Unit of measure: Number and percentage of participants (n, %) |
| History of Epilepsy Prior to SE | Baseline (day 1) | Presence or absence of a previously established epilepsy diagnosis, as documented in the medical record before the index SE event. Categories: yes / no Aggregation method / Unit of measure: Number and percentage of participants (n, %) |
| Guideline-based Treatment of SE | During hospital stay, maximum 30 days | Adherence to evidence-based guideline recommendations for the stepwise treatment of SE. Guideline adherence will be evaluated according to the following treatment algorithm (Rosenow and Weber, 2000): 1. Initial treatment with sufficient doses of intravenous lorazepam, intramuscular or intranasal midazolam, or intravenous diazepam. 2. Escalation to intravenous valproic acid or levetiracetam, and if needed, phenytoin or lacosamide. 3. For refractory SE, intensive care unit (ICU) admission with intubation and administration of intravenous anesthetics (propofol, midazolam, or thiopental). Categories: treatment according to guidelines; treatment not according to guidelines Aggregation method / Unit of measure: Number and percentage of participants (n, %) |
| Intubation During Treatment of SE | During hospital stay, maximum 30 days | Requirement for endotracheal intubation as part of the management of SE, documented in the medical record. Intubation was typically performed in the context of refractory SE and/or administration of intravenous anesthetics. Categories: intubated; not intubated Aggregation method / Unit of measure: Number and percentage of participants (n, %) |
| History of Epilepsy Surgery | Baseline (day 1) | Documentation of whether the patient had undergone epilepsy surgery prior to the index SE event, as recorded in the medical history. Categories: previous epilepsy surgery; no previous epilepsy surgery Aggregation method / Unit of measure: Number and percentage of participants (n, %) |
| Length of Hospital Stay | Up to 100 days | Duration of hospitalization in days for the index admission due to SE, documented in the medical record. Data will be summarized as mean and standard deviation (SD). Unit of measure: Days (mean, SD) |
| Availability of Brain MRI During Hospital Stay | During hospital stay, maximum 30 days | Documentation of whether a brain MRI was performed and available for diagnostic evaluation during hospitalization for SE. Categories: MRI available; MRI not available Aggregation method / Unit of measure: Number and percentage of participants (n, %) |
| Time to Brain MRI After SE Onset | During hospital stay, maximum 30 days | Number of days between the onset of SE and the performance of a brain MRI, as documented in the medical record. Unit of measure: Days (mean, SD) |
| EEG with SE Available | During hospital stay, maximum 30 days | Documentation of whether an EEG demonstrating SE was performed and available during hospitalization. Categories: EEG available; EEG not available Aggregation method / Unit of measure: Number and percentage of participants (n, %) |
| EEG Control Available | From hospital stay through follow-up (up to study completion, an average of 1 year) | Documentation of whether a follow-up EEG (control EEG) was performed after the initial EEG confirming SE, as recorded in the medical record. Categories: EEG control available; EEG control not available Aggregation method / Unit of measure: Number and percentage of participants (n, %) |
| Functional Outcome at Discharge (mRS) | Through study completion, an average of 12 days | Functional status at hospital discharge measured by the modified Rankin Scale (mRS) (mRS, range 0-6, where 0 = no symptoms and 6 = death). Unit of measure: mRS score (mean, SD) |
| Discharge Destination | Through study completion, an average of 12 days | Place of discharge following hospitalization for SE. Categories: home; rehabilitation; another clinic; deceased Aggregation method / Unit of measure: Number and percentage of participants (n, %) |
| Survival After One Year | One year after SE onset | Vital status one year after the index SE event, ascertained from medical records. Categories: alive; deceased Aggregation method / Unit of measure: Number and percentage of participants (n, %) |
| Total Costs of Hospital Stay | Through study completion, an average of 12 days | Total costs of hospitalization for SE as documented in hospital billing records. Unit of measure: Euro (mean, SD) |
| Antiseizure Medication (ASM) Use Prior to SE | Baseline (day 1) | Documentation of chronic ASM treatment prior to the index SE. Categories: yes; no Unit of measure: n, % |
| Number of Distinct ASMs Prior to SE | Baseline (day 1) | Number of different ASMs prescribed per patient prior to the index SE. Unit of measure: mean (SD) |
| Type of ASMs Used Prior to SE | Baseline (day 1) | Specific ASMs used prior to SE, including brivaracetam, carbamazepine, clobazam, clonazepam, diazepam, eslicarbazepine, ethosuximide, gabapentin, lacosamide, levetiracetam, lamotrigine, lorazepam, midazolam, oxcarbazepine, perampanel, phenobarbital, phenytoin, primidone, retigabine, rufinamide, stiripentol, topiramate, valproate, vigabatrin, zonisamide. Unit of measure: n, % for each substance |
| Prehospital Benzodiazepine Use Before SE | Baseline (day 1) | Documentation of whether a benzodiazepine was administered prior to hospital admission for SE. Categories: yes; no Unit of measure: n, % |
| Number of Distinct Prehospital Benzodiazepines | Baseline (day 1) | Number of different benzodiazepines administered per patient prior to hospital admission for SE. Unit of measure: mean (SD) |
| Type of Prehospital Benzodiazepines Used | Baseline (day 1) | Specific benzodiazepines administered prior to hospital admission for SE, including clonazepam, diazepam, lorazepam, midazolam. Unit of measure: n, % for each substance |
| ASM Use During SE Treatment | During hospital stay, maximum 30 days | Documentation of whether an ASM was administered during hospitalization for SE. Categories: yes; no Unit of measure: n, % |
| Number of Distinct ASMs During SE | During hospital stay, maximum 30 days | Number of different ASMs administered per patient during hospitalization for SE. Unit of measure: mean (SD) |
| Type of ASMs Used During SE | During hospital stay, maximum 30 days | Specific ASMs administered during hospitalization for SE, including brivaracetam, carbamazepine, clobazam, clonazepam, eslicarbazepine, gabapentin, lacosamide, levetiracetam, lamotrigine, lorazepam, oxcarbazepine, perampanel, phenobarbital, phenytoin, primidone, retigabine, rufinamide, stiripentol, topiramate, valproate, vigabatrin, zonisamide. Unit of measure: n, % for each substance |
| In-hospital Benzodiazepine Use | During hospital stay, maximum 30 days | Documentation of whether a benzodiazepine was administered during hospitalization for SE. Categories: yes; no Unit of measure: n, % |
| Number of Distinct In-hospital Benzodiazepines | During hospital stay, maximum 30 days | Number of different benzodiazepines administered per patient during hospitalization for SE. Unit of measure: mean (SD) |
| Type of In-hospital Benzodiazepines Used | During hospital stay, maximum 30 days | Specific benzodiazepines administered during hospitalization for SE, including lorazepam, diazepam, midazolam, clonazepam, clobazam. Unit of measure: n, % for each substance |
Outcome results
None listed