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CLINICAL CORRELATES OF INTRAVENOUS ANESTHETIC DRUG USE
Uysal, Utku
Uysal, Utku
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Abstract
Objective: To determine factors associated with continuous IV anesthetic drug (IVAD) use in nonconvulsive status epilepticus (NCSE). Methods: For this retrospective descriptive cohort study, we included all patients who met clinical and EEG criteria of NCSE from 2009 to 2014 at a tertiary academic medical center. Patients were categorized according to IVAD use. Primary outcome variables were response to treatment and in-hospital death. We used descriptive analyses for baseline characteristics, and primary and secondary outcome variables differences among patients who received IVAD and who did not receive IVAD. Results: Forty-three patients had a total of 45 NCSE episodes. IVAD was used in 69% of the episodes. Patients treated with IVAD were younger (53.1±14.1 vs 64.1±13.3, p=0.0187). The episodes treated with IVAD were associated with more acute neurologic pathology (58% vs 21%, p=0.0236) and more commonly presenteded in comatose patients (39% vs 7%, p=0.0299). Underlying epilepsy was common in both groups (36% in IVAD vs 42% in no-IVAD group). NCSE resolved in 74% of the patients who received IVAD. There were total 13 in-hospital deaths (ten in IVAD users vs three in the no-IVAD group). Only one in-hospital death appeared to be a direct consequence of IVAD. Conclusion: Our findings showed factors such as younger age, acute neurologic pathology and coma at presentation were associated with IVAD use in patients with NCSE. More patients died in IVAD group although this was not statistically significant. There is a need of further studies to determine the effect of IVAD use in NCSE on outcome, and these factors should be controlled in the future outcome and effectiveness studies.
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Date
2015-05-31
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University of Kansas
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Keywords
Medicine, Anesthetic drugs, Antiepileptic drugs, Benzodiasepines, Nonconvulsive status epilepticus, Status Epilepticus