Long‐term prognosis related to deep sedation in refractory status Epilepticus
Adult
Male
Adolescent
Midazolam
Middle Aged
Prognosis
3. Good health
Young Adult
03 medical and health sciences
Status Epilepticus
Treatment Outcome
0302 clinical medicine
Barbiturates
Multivariate Analysis
Humans
Hypnotics and Sedatives
Female
Longitudinal Studies
Coma
Deep Sedation
Propofol
Aged
Retrospective Studies
DOI:
10.1111/ane.13302
Publication Date:
2020-07-02T09:43:19Z
AUTHORS (10)
ABSTRACT
To evaluate long-term prognosis in patients with refractory status epilepticus according to the level of sedation reached during drug-induced coma.Longitudinal study of patients with status epilepticus who received anesthetics to induce therapeutic coma. Demographic data, clinical, and electroencephalographic characteristics were collected, as well as variables related to sedation. We considered as deep sedation the EEG burst-suppression patterns (suppression ratio > 50%). A GOSE (Glasgow Outcome Scale Extended) score of 7 or 8 was considered as good prognosis. A comparative study was carried out to identify predictors of good or poor prognosis at discharge, at 1 and 2 years of follow-up.We included 61 patients: 63.9% were men; mean age 53.5 ± 16.8 years (range 16-86 years), 39.3% reached deep sedation; 62.3% had > 48 h induced coma. The median hospital stay was 21 days, while 10 days in the intensive care unit (ICU). In the multiple regression analysis, an ICU length of stay ≥ 7 days was associated with poor prognosis at discharge and at long-term (P < .05), while deep sedation was associated only with poor long-term prognosis (1 and 2 years, P < .05). The Kaplan-Meier curve showed higher survival in the group that did not undergo deep sedation (P < .05).In refractory status epilepticus, deep sedation is associated with poor prognosis at long-term.
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