Timing of benzodiazepine treatment and mortality in adult patients with generalized convulsive status epilepticus

Status epilepticus is an emergency condition with a high mortality rate. However, there is currently limited data on the timing of antiepileptic drugs (AED) and mortality, particularly generalized convulsive status epilepticus. This study aims to evaluate if early AED treatment is associated with mortality in patients with generalized convulsive status epilepticus. This was a retrospective cohort study, which enrolled patients 18 years or over who had been diagnosed with generalized convulsive status epilepticus and had discharge status. Eligible patients were selected from the database of University Hospital. Predictors for mortality were analyzed by logistic regression analysis. A total of 77 patients met the study criteria; of those 27 patients (35.06 %) died. There were seven factors included in the stepwise multivariable logistic regression analysis. Among those, only five factors were retained in the predictive model for mortality: These included the time from seizure onset to benzodiazepine treatment, the time from the seizure onset to the first AED, number of AEDs, AED withdrawal, and Status Epilepticus Severity Score (STESS). Of those, only the time from seizure onset to benzodiazepine treatment and the STESS were independently associated with mortality with adjusted odds ratios of 1.03 (95 % confidence interval of 1.01, 1.06) and 1.54 (95 % confidence interval of 1.08, 2.22), respectively. Sensitivity of time from seizure onset to benzodiazepine treatment of five minutes or more had a sensitivity of 100 %. Early treatment with benzodiazepine, that is within five minutes after the occurrence of status epilepticus may lower mortality rate in adult patients with generalized convulsive status epilepticus.