Association of early general anesthesia with outcome in adults with status epilepticus: A propensity‐matched observational study
General anesthesia (GA) earlier than recommended (as first- or second-line treatment) was recently described to improve status epilepticus (SE) outcome. We aimed to assess the impact of early GA on outcome in matched groups. Data from a multicenter, prospective cohort of 1179 SE episodes in 1049 adults were retrospectively analyzed. Incident SE episodes were categorized as "early anesthesia" (eGA; GA as first- or second-line treatment) or "non-early anesthesia" (neGA; GA after second-line treatment or not at all). Using propensity score matching, eGA episodes were paired 1:4 with neGA episodes. We assessed survival, functional outcomes at discharge (good: modified Rankin Scale = 0-2 or no worsening), SE cessation rate, SE duration, and hospital stay. Among 1049 SE episodes, 55 (5.2%) received eGA, and 994 constituted the neGA group; 220 represented the matched controls. Patients receiving eGA were younger (median = 63, interquartile range [IQR] = 56-76 vs. median = 70, IQR = 54-80 years, p = .004), had deeper consciousness impairment (80% vs. 40% stuporous/comatose, p < .001), and had more severe SE forms (89% vs. 54% generalized convulsive SE/nonconvulsive SE in coma, p < .001). Mortality, functional outcome, SE cessation rate, and duration of SE and hospital stay were similar between the eGA group and matched controls. We conclude that early anesthesia for SE treatment did not influence prognosis.
Authors
- Jan Nový (ORCID: https://orcid.org/0000-0002-6862-7083)
- Iris Unterberger (ORCID: https://orcid.org/0000-0001-6408-5777)
- Andrea O. Rossetti (ORCID: https://orcid.org/0000-0002-7878-172X)
- Christoph Kellinghaus (ORCID: https://orcid.org/0000-0001-5491-2302)
- Vincent Alvarez (ORCID: https://orcid.org/0000-0002-2489-4577)
- Felix Rosenow
- Željko Uzelac (ORCID: https://orcid.org/0000-0003-2479-2025)
- Adam Strzelczyk (ORCID: https://orcid.org/0000-0001-6288-9915)
- Christian Tilz
- Isabelle Beuchat (ORCID: https://orcid.org/0000-0002-9300-4443)
- Eugen Trinka (ORCID: https://orcid.org/0000-0002-5950-2692)
- Stephan J. Rüegg (ORCID: https://orcid.org/0000-0002-5836-622X)
Institutions
- Goethe University Frankfurt (DE)
- Innsbruck Medical University (AT)
- Philipps University of Marburg (DE)
- Osnabrück University (DE)
- University of Basel (CH)
- Paracelsus Medical University (AT)
- Centre Hospitalier Universitaire Vaudois (CH)
- University Hospital of Basel (CH)
- Ravensburg University of Cooperative Education (DE)
- LOEWE Centre for Translational Biodiversity Genomics (DE)
- University Hospital Frankfurt (DE)
- Klinikum Osnabrück (DE)
- University Hospital Ulm (DE)
- Hôpital du Valais (CH)
- Karl Landsteiner Society (AT)
- University of Lausanne (CH)
Publication Details
- Journal
- Epilepsia
- Published
- 2024-11-28
- DOI
- https://doi.org/10.1111/epi.18203
- Citations
- 4
- Primary Topic
- Epilepsy research and treatment
- Type
- article
- Field-Weighted Citation Impact
- 1.54