AI Article Synopsis
- The study aimed to evaluate the effectiveness of the health care system in treating status epilepticus (SE) in Auckland, New Zealand, focusing on treatment patterns and outcomes.
- A total of 365 patients were evaluated, with notable findings including that over half had prior epilepsy, the average duration of SE was 44 minutes, and key factors affecting SE duration included early benzodiazepine administration.
- The results indicated lower-than-expected mortality rates and self-limiting cases of SE, while showing no disparities in treatment or outcomes across different ethnic groups, emphasizing the strengths of a universal health care system.
Article Abstract
Objective: Determination of the real-world performance of a health care system in the treatment of status epilepticus (SE).
Methods: Prospective, multicenter population-based study of SE in Auckland, New Zealand (NZ) over 1 year, with data recorded in the EpiNet database. Focus on treatment patterns and determinants of SE duration and 30-day mortality. The incidence, etiology, ethnic discrepancies, and seizure characteristics of this cohort have been published previously.
Results: A total of 365 patients were included in this treatment cohort; 326 patients (89.3%) were brought to hospital because of SE, whereas 39 patients (10.7%) developed SE during a hospital admission for another reason. Overall, 190 (52.1%) had a known history of epilepsy and 254 (70.0%) presented with SE with prominent motor activity. The mean Status Epilepticus Severity Score (STESS) was 2.15 and the mean SE duration of all patients was 44 min. SE self-terminated without any treatment in 84 patients (22.7%). Earlier administration of appropriately dosed benzodiazepine in the pre-hospital setting was a major determinant of SE duration. Univariate analysis demonstrated that mortality was significantly higher in older patients, patients with longer durations of SE, higher STESS, and patients who developed SE in hospital, but these did not maintain significance with multivariate analysis. There was no difference in the performance of the health care system in the treatment of SE across ethnic groups.
Significance: When SE was defined as 10 continuous minutes of seizure, overall mortality was lower than expected and many patients had self-limited presentations for which no treatment was required. Although there were disparities in the incidence of SE across ethnic groups there was no difference in treatment or outcome. The finding highlights the benefit of a health care system designed to deliver universal health care.
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| http://dx.doi.org/10.1111/epi.17975 | DOI Listing |
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