Abstract：
OBJECTIVE: To document the 2-year mortality and seizure recurrence rate of a prospective cohort of patients identified with status epilepticus (SE).
METHODS: Patients presenting to any hospital in the Auckland region between April 6 2015, and April 5 2016, with a seizure lasting 10 min or longer were identified. Follow up was at 2 years post index SE episode via telephone calls and detailed review of clinical notes.
RESULTS: We identified 367 patients with SE over the course of one year. 335/367 (91.3 %) were successfully followed up at the 2-year mark. Two-year all-cause mortality was 50/335 (14.9 %), and 49/267 (18.4 %) when febrile SE was excluded. Two-year seizure recurrence was 197/335 (58.8 %). On univariate analyses, children (preschoolers 2 to < 5 years and children 5 to < 15 years), Asian ethnicity, SE duration <30 mins and acute (febrile) aetiology were associated with lower mortality, while older age >60 and progressive causes were associated with higher mortality on both univariate and multivariate analyses. Age < 2 years and acute aetiology were associated with lower seizure recurrence, while non convulsive status epilepticus (NCSE) with coma and a history of epilepsy were associated with higher seizure recurrence. On multivariate analyses, a history of epilepsy, as well as having both acute and remote causes were associated with higher seizure recurrence.
CONCLUSIONS: All-cause mortality in both the paediatric and adult populations at 2 years was lower than most previous reports. Older age, SE duration ≥30 mins and progressive aetiologies were associated with the highest 2-year mortality, while febrile SE had the lowest mortality. A history of epilepsy, NCSE with coma, and having both acute and remote causes were associated with higher seizure recurrence at 2 years. Future studies should focus on functional measures of outcome and long-term quality of life.
METHODS: Patients presenting to any hospital in the Auckland region between April 6 2015, and April 5 2016, with a seizure lasting 10 min or longer were identified. Follow up was at 2 years post index SE episode via telephone calls and detailed review of clinical notes.
RESULTS: We identified 367 patients with SE over the course of one year. 335/367 (91.3 %) were successfully followed up at the 2-year mark. Two-year all-cause mortality was 50/335 (14.9 %), and 49/267 (18.4 %) when febrile SE was excluded. Two-year seizure recurrence was 197/335 (58.8 %). On univariate analyses, children (preschoolers 2 to < 5 years and children 5 to < 15 years), Asian ethnicity, SE duration <30 mins and acute (febrile) aetiology were associated with lower mortality, while older age >60 and progressive causes were associated with higher mortality on both univariate and multivariate analyses. Age < 2 years and acute aetiology were associated with lower seizure recurrence, while non convulsive status epilepticus (NCSE) with coma and a history of epilepsy were associated with higher seizure recurrence. On multivariate analyses, a history of epilepsy, as well as having both acute and remote causes were associated with higher seizure recurrence.
CONCLUSIONS: All-cause mortality in both the paediatric and adult populations at 2 years was lower than most previous reports. Older age, SE duration ≥30 mins and progressive aetiologies were associated with the highest 2-year mortality, while febrile SE had the lowest mortality. A history of epilepsy, NCSE with coma, and having both acute and remote causes were associated with higher seizure recurrence at 2 years. Future studies should focus on functional measures of outcome and long-term quality of life.
摘要：
目的：记录确定为癫痫持续状态（SE）的患者的2年死亡率和癫痫复发率。
方法：确定了2015年4月6日至2016年4月5日期间到奥克兰地区任何一家医院就诊的癫痫发作持续10分钟或更长时间的患者。在SE发作后2年通过电话和临床记录的详细审查进行随访。
结果：我们在一年的病程中确定了367例SE患者。335/367（91.3%）在2年时成功随访。两年全因死亡率为50/335（14.9%），和49/267（18.4%）时，高热SE被排除。两年的癫痫复发为197/335（58.8％）。在单变量分析中，儿童（2至<5岁的学龄前儿童和5至<15岁的儿童），亚洲种族,SE持续时间<30分钟和急性（发热）病因与较低的死亡率相关。在单因素和多因素分析中,年龄>60岁和进展原因与较高的死亡率相关.年龄<2岁和急性病因与低发作复发相关，而非惊厥性癫痫持续状态（NCSE），昏迷和癫痫病史与更高的癫痫发作复发有关。在多变量分析中，癫痫病史,以及急性和远端原因与更高的癫痫发作复发相关。
结论：儿童和成人人群在2年时的全因死亡率低于大多数以前的报告。年纪大了,SE持续时间≥30分钟和进行性病因与最高的2年死亡率相关，而高热SE的死亡率最低。癫痫病史,NCSE昏迷,同时有急性和远端原因与2年时更高的癫痫发作复发率相关.未来的研究应侧重于结果和长期生活质量的功能测量。
方法：确定了2015年4月6日至2016年4月5日期间到奥克兰地区任何一家医院就诊的癫痫发作持续10分钟或更长时间的患者。在SE发作后2年通过电话和临床记录的详细审查进行随访。
结果：我们在一年的病程中确定了367例SE患者。335/367（91.3%）在2年时成功随访。两年全因死亡率为50/335（14.9%），和49/267（18.4%）时，高热SE被排除。两年的癫痫复发为197/335（58.8％）。在单变量分析中，儿童（2至<5岁的学龄前儿童和5至<15岁的儿童），亚洲种族,SE持续时间<30分钟和急性（发热）病因与较低的死亡率相关。在单因素和多因素分析中,年龄>60岁和进展原因与较高的死亡率相关.年龄<2岁和急性病因与低发作复发相关，而非惊厥性癫痫持续状态（NCSE），昏迷和癫痫病史与更高的癫痫发作复发有关。在多变量分析中，癫痫病史,以及急性和远端原因与更高的癫痫发作复发相关。
结论：儿童和成人人群在2年时的全因死亡率低于大多数以前的报告。年纪大了,SE持续时间≥30分钟和进行性病因与最高的2年死亡率相关，而高热SE的死亡率最低。癫痫病史,NCSE昏迷,同时有急性和远端原因与2年时更高的癫痫发作复发率相关.未来的研究应侧重于结果和长期生活质量的功能测量。
