Mortality, causes and predictors of death in status epilepticus (P5.087)

OBJECTIVE: To evaluate short and long-term mortality, causes and predictors of death in patients with status epilepticus (SE) BACKGROUND: Over the decades, there have been many studies that analyze acute mortality and predictors for mortality in SE, but there are still not enough data about short- or long-term mortality, and predictors of death in SE. DESIGN/METHODS: We retrospectively identified 147 patients over 15 years-old who were treated because of SE in Asan medical center in Korea from January 1989 to December 2010. We excluded 18 patients who had underlying diseases which may cause SE or death itself. Finally total 129 patients were included in this analysis. Medical records of patients were reviewed in detail and information on the cause of death was collected from the National Statistics Office database. RESULTS: Among 129 patients, viral encephalitis was the most common cause of SE (71 cases, 55[percnt]), followed by known seizures (44 cases, 34.1 [percnt]). 40 patients were died (31.01[percnt]) because of acute complication of SE (31 cases, 77.5[percnt]), underlying disease (5 cases, 12.5[percnt]), suicide (2 cases, 5[percnt]), accident (1 case, 2.5[percnt]) and unknown cause (1 case, 2.5[percnt]). In whom, 23 patients (57.5[percnt]) died during acute period and 17 (42.5[percnt]) died during long-term period. Long-term and short-term mortality was significantly higher in patients with an etiology of encephalitis (40.8[percnt], P=0.008), patients who were required treatment with midazolam (42.9[percnt], P=0.043), and coma therapy using pentobarbital (51.2[percnt], P=0.000). There was also a significantly increased mortality in patients with de novo seizure compared with those who had a pre-exist seizure disorder (40.2[percnt], P=0.003). CONCLUSIONS: Our results indicate that encephalitis, treatment with midazolam or coma therapy and de novo seizure patients are the predictors of death in SE. Also, Mortality in acute period is higher than mortality in long-term period. Disclosure: Dr. Lee has nothing to disclose. Dr. Choi has nothing to disclose. Dr. Hong has nothing to disclose. Dr. Kang has nothing to disclose.