ABSTRACT
Objective To explore the factors affecting the prognosis of children with status epilepticu(s SE). Methods A retrospective review was performed on children and the outcomes were measured by Glasgow Outcome Score(GOS). GOS=5 was defined as a good outcome,and GOS<5 as a bad outcome. Results (1)Two hundred and ninety-eight children(163 girls and 135 boys)with SE were enrolled. The ages of the patients ranged from 2 months and 7 days to 14 years and 5 months,and 106 cases were at 1-3 years old. There were 154 cases(51. 68% )with pre-vious history of convulsion,including 98 cases of epilepsy(63. 63% )and 241 new onset SE(80. 87% ). The most common cause of SE in children was febrile seizure(92 cases,accounting for 30. 87% ),followed by long-term symp-tom(81 cases,accounting for 27. 18% ). A total of 109 cases(41. 90% )were treated with Diazepam in time after the convulsion,and 151 cases(58. 10% )were treated with antiepileptic drugs such as Phenobarbital sodium or Chloral hy-drate after the convulsion. Based on GOS scale,the near-term prognosis was as follows:254 cases(85. 23% )of chil-dren with GOS=5,and the remaining 44 cases of GOS<5 points.(2)Recent overall prognostic factors:single factor analysis showed that a total of 12 factors were associated with poor prognosis(P<0. 05),including age,Pediatric In-tensive Care Unit(PICU),tracheal intubation,previous history of convulsions,developmental delay,new onset of SE, fever,comprehensive onset,refractory SE,electroencephalogram( EEG)abnormality,neuroimaging abnormality and etiology. Multiple factor Logistic regression analysis showed that PICU monitoring was required( OR=4. 306,95% CI:1. 554-11. 933,P=0. 005),developmental delay(OR=3. 054,95% CI:1. 157-8. 066,P=0. 024),and abnormal cranial image(OR=2. 110,95% CI:1. 121-3. 970,P=0. 021)was an independent risk factors for short-term poor prognosis. Comprehensive onset(OR=0. 330,95% CI:0. 139-0. 782;P=0. 012),and the cause of febrile convulsion (OR=0. 688,95% CI:0. 480-0. 987,P=0. 042)were prognostic non-risk factor.(3)Recent prognostic factors in PICU monitoring group:the hospitalization time of PICU,developmental delay,the atypical attack type,electroencepha-logram abnormality,neuroimaging abnormality,and the etiology of these 6 factors were correlated with the prognosis of PICU group,among which prolonged PICU(OR=36. 912,95% CI:5. 165-263. 787,P=0. 000)and developmental delay(OR=14. 403,95% CI:1. 725-120. 273,P=0. 014)were independent risk factors for poor outcome of PICU monitoring group. Conclusions PICU monitoring,developmental backwardness and abnormal head image are the inde-pendent risk factors for poor prognosis. PICU residence time and developmental delay are the independent risk factors for poor short-term prognosis in PICU enrolled children.
ABSTRACT
Objective@#To explore the factors affecting the prognosis of children with status epilepticus(SE).@*Methods@#A retrospective review was performed on children and the outcomes were measured by Glasgow Outcome Score (GOS). GOS=5 was defined as a good outcome, and GOS<5 as a bad outcome.@*Results@#(1)Two hundred and ninety-eight children (163 girls and 135 boys) with SE were enrolled.The ages of the patients ranged from 2 months and 7 days to 14 years and 5 months, and 106 cases were at 1-3 years old.There were 154 cases (51.68%) with previous history of convulsion, including 98 cases of epilepsy (63.63%) and 241 new onset SE (80.87%). The most common cause of SE in children was febrile seizure (92 cases, accounting for 30.87%), followed by long-term symptom (81 cases, accounting for 27.18%). A total of 109 cases (41.90%) were treated with Diazepam in time after the convulsion, and 151 cases (58.10%) were treated with antiepileptic drugs such as Phenobarbital sodium or Chloral hydrate after the convulsion.Based on GOS scale, the near-term prognosis was as follows: 254 cases(85.23%) of children with GOS=5, and the remaining 44 cases of GOS<5 points.(2) Recent overall prognostic factors: single factor analysis showed that a total of 12 factors were associated with poor prognosis (P<0.05), including age, Pediatric Intensive Care Unit (PICU), tracheal intubation, previous history of convulsions, developmental delay, new onset of SE, fever, comprehensive onset, refractory SE, electroencephalogram (EEG) abnormality, neuroimaging abnormality and etiology.Multiple factor Logistic regression analysis showed that PICU monitoring was required (OR=4.306, 95%CI: 1.554-11.933, P=0.005), developmental delay (OR=3.054, 95%CI: 1.157-8.066, P=0.024), and abnormal cranial image (OR=2.110, 95%CI: 1.121-3.970, P=0.021) was an independent risk factors for short-term poor prognosis.Comprehensive onset (OR=0.330, 95%CI: 0.139-0.782; P=0.012), and the cause of febrile convulsion (OR=0.688, 95%CI: 0.480-0.987, P=0.042) were prognostic non-risk factor.(3)Recent prognostic factors in PICU monitoring group: the hospitalization time of PICU, developmental delay, the atypical attack type, electroencephalogram abnormality, neuroimaging abnormality, and the etiology of these 6 factors were correlated with the prognosis of PICU group, among which prolonged PICU (OR=36.912, 95%CI: 5.165-263.787, P=0.000) and developmental delay (OR=14.403, 95%CI: 1.725-120.273, P=0.014) were independent risk factors for poor outcome of PICU monitoring group.@*Conclusions@#PICU monitoring, developmental backwardness and abnormal head image are the independent risk factors for poor prognosis.PICU residence time and developmental delay are the independent risk factors for poor short-term prognosis in PICU enrolled children.