title: Status epilepticus: an independent outcome predictor after cerebral anoxia.
abstract: BACKGROUND
  Prognosis of status epilepticus (SE) depends on its cause, but there is uncertainty as to whether SE represents an independent outcome predictor for a given etiology. Cerebral anoxia is a relatively homogenous severe encephalopathy. Postanoxic SE is associated to a nearly 100% mortality in this setting; however, it is still unclear whether this is a severity marker of the underlying encephalopathy, or an independent factor influencing outcome. The goal of this study was to assess if postanoxic SE is independently associated with mortality after cerebral anoxia.
  
  
  METHODS
  This was a retrospective observation of consecutive comatose survivors of cardiac arrest, including subjects treated with hypothermia. On the subgroup with EEG recordings in the first hospitalization days, univariate and multivariate analyses were applied to potential determinants of in-hospital mortality, and included the following variables: age, gender, type and length of cardiac arrest, occurrence of circulatory shock, presence of therapeutic hypothermia, and electrographic SE.
  
  
  RESULTS
  Out of 166 postanoxic patients, 107 (64%) had an EEG (median latency from admission, 2 days); in this group, therapeutic hypothermia was administered in 59%. Death occurred in 71 (67%) patients. Postanoxic SE was associated with mortality regardless of type of acute cardiac rhythm and administration of hypothermic treatment.
  
  
  CONCLUSIONS
  In this hospital-based cohort, postanoxic status epilepticus (SE) seems to be independently related to death in cardiac arrest survivors, suggesting that SE might determine a bad prognosis for a given etiology. Confirmation of these results in a prospective assessment is needed.
authors.affiliation: Service de Neurologie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. andrea.rossetti@chuv.ch
authors.forename: A O
authors.initials: AO
authors.lastname: Rossetti
authors.forename: G
authors.initials: G
authors.lastname: Logroscino
authors.forename: L
authors.initials: L
authors.lastname: Liaudet
authors.forename: C
authors.initials: C
authors.lastname: Ruffieux
authors.forename: V
authors.initials: V
authors.lastname: Ribordy
authors.forename: M D
authors.initials: MD
authors.lastname: Schaller
authors.forename: P A
authors.initials: PA
authors.lastname: Despland
authors.forename: M
authors.initials: M
authors.lastname: Oddo
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006323:Heart Arrest / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D002534:Hypoxia, Brain / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013226:Status Epilepticus / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome