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Critical Care
Published in: Critical Care 1/2017

Open Access 01-12-2017 | Research

Predictors of hospital and one-year mortality in intensive care patients with refractory status epilepticus: a population-based study

Authors: Anne-Mari Kantanen, Reetta Kälviäinen, Ilkka Parviainen, Marika Ala-Peijari, Tom Bäcklund, Juha Koskenkari, Ruut Laitio, Matti Reinikainen

Published in: Critical Care | Issue 1/2017

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Abstract

Background

The aim was to determine predictors of hospital and 1-year mortality in patients with intensive care unit (ICU)-treated refractory status epilepticus (RSE) in a population-based study.

Methods

This was a retrospective study of the Finnish Intensive Care Consortium (FICC) database of adult patients (16 years of age or older) with ICU-treated RSE in Finland during a 3-year period (2010–2012). The database consists of admissions to all 20 Finnish hospitals treating RSE in the ICU. All five university hospitals and 11 out of 15 central hospitals participated in the present study. The total adult referral population in the study hospitals was 3.92 million, representing 91% of the adult population of Finland. Patients whose condition had a post-anoxic aetiological basis were excluded.

Results

We identified 395 patients with ICU-treated RSE, corresponding to an annual incidence of 3.4/100,000 (95% confidence interval (CI) 3.04–3.71). Hospital mortality was 7.4% (95% CI 0–16.9%), and 1-year mortality was 25.4% (95% CI 21.2–29.8%). Mortality at hospital discharge was associated with severity of organ dysfunction. Mortality at 1 year was associated with older age (adjusted odds ratio (aOR) 1.033, 95% CI 1.104–1.051, p = 0.001), sequential organ failure assessment (SOFA) score (aOR 1.156, CI 1.051–1.271, p = 0.003), super-refractory status epilepticus (SRSE) (aOR 2.215, 95% CI 1.20–3.84, p = 0.010) and dependence in activities of daily living (ADL) (aOR 2.553, 95% CI 1.537–4.243, p < 0.0001).

Conclusions

Despite low hospital mortality, 25% of ICU-treated RSE patients die within a year. Super-refractoriness, dependence in ADL functions, severity of organ dysfunction at ICU admission and older age predict long-term mortality.

Trial registration

Retrospective registry study; no interventions on human participants.
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Metadata
Title
Predictors of hospital and one-year mortality in intensive care patients with refractory status epilepticus: a population-based study
Authors
Anne-Mari Kantanen
Reetta Kälviäinen
Ilkka Parviainen
Marika Ala-Peijari
Tom Bäcklund
Juha Koskenkari
Ruut Laitio
Matti Reinikainen
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2017
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-017-1661-x

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