Status epilepticus after stroke is associated with increased long-term case fatality.
OBJECTIVE
The aim of this study was to determine the long-term case fatality of patients with a first episode of status epilepticus (SE group) of cerebrovascular etiology, as compared with that in acute stroke patients without SE (AS group).


METHODS
Patients with SE who had been prospectively admitted to an epidemiologic study were retrospectively compared with a cohort of patients from the local stroke registry. The main outcome end point was overall survival. Survival curves were generated according to the Kaplan-Meier method and compared by using the log-rank test. An extended Cox model was used to examine the impact of patient group on the risk of death. Covariates considered potential confounders included age at diagnosis, sex, type of stroke, affected hemisphere, and localization of lesions.


RESULTS
Of 166 patients who entered the study, 93 patients were in the SE group, and 73 patients were in the AS group; 53 SE patients and 35 AS patients died during the study. Patient group (SE vs. AS) showed no significant impact on survival (p=0.0832) in univariate analysis. In contrast, the results from a multivariable analysis suggest that after 6 months, patients with SE were at about twice the risk of death as were patients with AS [hazard ratio of 2.12 with 95% confidence interval, 1.04-4.32, p=0.0392].


CONCLUSIONS
The occurrence of SE in patients with cerebrovascular disease indicates a high risk of death within 3 years. In contrast, the case fatality risk attributable to recurrent status or seizures is lower.
Knake
Susanne
S
Department of Neurology, Interdisciplinary Epilepsy Center, University Hospital Giessen and Marburg, Marburg, Germany.
Rochon
Justine
J
Fleischer
Sarah
S
Katsarou
Niki
N
Back
Tobias
T
Vescovi
Mathias
M
Oertel
Wolfgang H
WH
Reis
Janine
J
Hamer
Hajo M
HM
Rosenow
Felix
F
D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality; D005858:Germany; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013226:Status Epilepticus / Q000209:etiology / Q000401:mortality*; D020521:Stroke / Q000150:complications* / Q000473:pathology; D015996:Survival Rate; D013997:Time Factors