Caracterización epidemiológica y factores relacionados con mal pronóstico en pacientes mayores de 18 años con estado epiléptico atendidos en el servicio de Neurología de la Fundación Cardioinfantil entre los años 2016 a 2018

Abstract

Status epilepticus (SE) is a prevalent neurological emergency, with consequences both primary in the central nervous system and secondary from a systemic point of view, with important aftermaths in terms of morbidity and mortality. The detection of risk factors involved in its appearance, perpetuation and complications, is needed in order to mitigate the damage produced along each stage of SE. Methodology: A descriptive observational case-series trial was conducted in patients over 18 years with status epilepticus treated in a high complexity university hospital in Bogotá, Colombia, between 2016-2018, describing clinical, paraclinical features and STESS (Status Epilepticus Severity Score) score. The data were analyzed using the SPSS platform (IBM Statistics). Results: A total sample of 83 patients was obtained for the final analysis. 63.9% were men, and the median age was 59 years. 85.5% of the patients had convulsive SE and in 50.6% of the cases they required ICU management. The etiology of SE was undetermined in 38.6%, followed by antiepileptic drug deprivation (20.5%). In general, 22.9% had complications, 47.4% related to the ICU stay, followed by associated with pharmacological treatment (26.3%). Mortality secondary to SE was 5.3%, while overall mortality was recorded at 16.9%. The mean hospital stay was 25 days in the group of patients with complications vs. 9 days in those without. The STESS score was found in an unfavorable range (≥3) in 44.5% and 29.7% in the group of patients with complications. Conclusions: Demographic, clinical, and paraclinical features, with focus on comorbidities, electroencephalographic patterns, and STESS score, could be related to the presence of complications and mortality in colombian patients with status epilepticus.