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Treatment delay in status epilepticus – more effective prehospital symptom recognition warranted
BACKGROUND: The outcome of status epilepticus (SE) can be improved by facilitating early recognition and treatment with antiepileptic drugs. The purpose of this study was to analyze the treatment delay of SE in a prospectively recruited patient cohort. Improvements to the treatment process are sugge...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6407251/ https://www.ncbi.nlm.nih.gov/pubmed/30845979 http://dx.doi.org/10.1186/s13049-019-0605-7 |
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author | Sairanen, Joni J. Kantanen, Anne-Mari Hyppölä, Harri T. Kälviäinen, Reetta K. |
author_facet | Sairanen, Joni J. Kantanen, Anne-Mari Hyppölä, Harri T. Kälviäinen, Reetta K. |
author_sort | Sairanen, Joni J. |
collection | PubMed |
description | BACKGROUND: The outcome of status epilepticus (SE) can be improved by facilitating early recognition and treatment with antiepileptic drugs. The purpose of this study was to analyze the treatment delay of SE in a prospectively recruited patient cohort. Improvements to the treatment process are suggested. METHODS: Consecutive adult patients with SE were recruited in the emergency department of Kuopio University Hospital (KUH) between March 23 and December 31, 2015. SE was defined as a prolonged (> 5 min) epileptic seizure or recurrent tonic-clonic seizures (≥ 3 seizures within any 24 h). Diagnostic and treatment delays and the features of SE were subject to statistical analysis. RESULTS: We recorded 151 cases of SE during the study period. First-line treatment was initiated outside of hospital in 79 cases (52.3%), with a significantly shorter median delay compared to intrahospital initiation (28 min vs. 2 h 5 min, p < 0.001). Forty-six episodes of SE (30.5%) were not recognized during the prehospital phase. The median delay in recognition of tonic-clonic SE (23 min) was significantly shorter than in focal aware (2 h 0 min, p = 0.045) or focal impaired awareness SE (2 h 25 min, p < 0.001). Second-line treatment was used in 91 cases (60.3%), with a median delay of 2 h 42 min. Anesthesia was used in seven cases (4.6%) with refractory SE, with a median delay of 6 h 40 min. CONCLUSIONS: SE is often not recognized during the prehospital phase of treatment, which delays the initiation of first-line treatment. Intrahospital delay could be reduced by streamlining patient transition between the three lines of treatment. |
format | Online Article Text |
id | pubmed-6407251 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-64072512019-03-21 Treatment delay in status epilepticus – more effective prehospital symptom recognition warranted Sairanen, Joni J. Kantanen, Anne-Mari Hyppölä, Harri T. Kälviäinen, Reetta K. Scand J Trauma Resusc Emerg Med Original Research BACKGROUND: The outcome of status epilepticus (SE) can be improved by facilitating early recognition and treatment with antiepileptic drugs. The purpose of this study was to analyze the treatment delay of SE in a prospectively recruited patient cohort. Improvements to the treatment process are suggested. METHODS: Consecutive adult patients with SE were recruited in the emergency department of Kuopio University Hospital (KUH) between March 23 and December 31, 2015. SE was defined as a prolonged (> 5 min) epileptic seizure or recurrent tonic-clonic seizures (≥ 3 seizures within any 24 h). Diagnostic and treatment delays and the features of SE were subject to statistical analysis. RESULTS: We recorded 151 cases of SE during the study period. First-line treatment was initiated outside of hospital in 79 cases (52.3%), with a significantly shorter median delay compared to intrahospital initiation (28 min vs. 2 h 5 min, p < 0.001). Forty-six episodes of SE (30.5%) were not recognized during the prehospital phase. The median delay in recognition of tonic-clonic SE (23 min) was significantly shorter than in focal aware (2 h 0 min, p = 0.045) or focal impaired awareness SE (2 h 25 min, p < 0.001). Second-line treatment was used in 91 cases (60.3%), with a median delay of 2 h 42 min. Anesthesia was used in seven cases (4.6%) with refractory SE, with a median delay of 6 h 40 min. CONCLUSIONS: SE is often not recognized during the prehospital phase of treatment, which delays the initiation of first-line treatment. Intrahospital delay could be reduced by streamlining patient transition between the three lines of treatment. BioMed Central 2019-03-07 /pmc/articles/PMC6407251/ /pubmed/30845979 http://dx.doi.org/10.1186/s13049-019-0605-7 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Original Research Sairanen, Joni J. Kantanen, Anne-Mari Hyppölä, Harri T. Kälviäinen, Reetta K. Treatment delay in status epilepticus – more effective prehospital symptom recognition warranted |
title | Treatment delay in status epilepticus – more effective prehospital symptom recognition warranted |
title_full | Treatment delay in status epilepticus – more effective prehospital symptom recognition warranted |
title_fullStr | Treatment delay in status epilepticus – more effective prehospital symptom recognition warranted |
title_full_unstemmed | Treatment delay in status epilepticus – more effective prehospital symptom recognition warranted |
title_short | Treatment delay in status epilepticus – more effective prehospital symptom recognition warranted |
title_sort | treatment delay in status epilepticus – more effective prehospital symptom recognition warranted |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6407251/ https://www.ncbi.nlm.nih.gov/pubmed/30845979 http://dx.doi.org/10.1186/s13049-019-0605-7 |
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