Analysis of factors influencing the short＿term prognosis of children With status epilepticus / 中华实用儿科临床杂志

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 follows254 cases(85. 23% )of chil-dren with GOS=5,and the remaining 44 cases of GOS<5 points.(2)Recent overall prognostic factorssingle 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% CI1. 554-11. 933,P=0. 005),developmental delay(OR=3. 054,95% CI1. 157-8. 066,P=0. 024),and abnormal cranial image(OR=2. 110,95% CI1. 121-3. 970,P=0. 021)was an independent risk factors for short-term poor prognosis. Comprehensive onset(OR=0. 330,95% CI0. 139-0. 782;P=0. 012),and the cause of febrile convulsion (OR=0. 688,95% CI0. 480-0. 987,P=0. 042)were prognostic non-risk factor.(3)Recent prognostic factors in PICU monitoring groupthe 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% CI5. 165-263. 787,P=0. 000)and developmental delay(OR=14. 403,95% CI1. 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.