title: Hospital mortality in primary admissions of septic patients with status epilepticus in the United States*.
abstract: OBJECTIVE
  To determine the prevalence of status epilepticus, associated factors, and relationship with in-hospital mortality in primary admissions of septic patients in the United States.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Primary admissions of adult patients more than 18 years old with a diagnosis of sepsis and status epilepticus from 1988 to 2008 identified through the Nationwide Inpatient Sample.
  
  
  METHODS
  A total of 7,669,125 primary admissions of patients with sepsis.
  
  
  METHODS
  None.
  
  
  RESULTS
  During the 21-year study period, the prevalence of status epilepticus in primary admissions of septic patients increased from 0.1% in 1988 to 0.2% in 2008 (p < 0.001). Status epilepticus was also more common among later years, younger admissions, female gender, Black race, rural hospital admissions, and in those patients with organ dysfunctions. Mortality of primary sepsis admissions decreased from 20% in 1988 to 18% in 2008 (p < 0.001). Mortality in status epilepticus during sepsis decreased from 43% in 1988 to 28% in 2008. In-hospital mortality after admissions for sepsis was associated with status epilepticus, older age, and Black and Native American/Eskimo race; patients admitted to a rural or urban private hospitals; and patients with organ dysfunctions.
  
  
  CONCLUSIONS
  Our analysis demonstrates that status epilepticus after admission for sepsis in the United States was rare. Despite an overall significant reduction in mortality after admission for sepsis, status epilepticus carried a higher risk of death. More aggressive electrophysiological monitoring and a high level of suspicion for the diagnosis of status epilepticus may be indicated in those patients with central nervous system organ dysfunction after sepsis.
authors.affiliation: Division of Critical Care and Neurotrauma, Department of Neurology, Thomas Jefferson University, Philadelphia, PA 19107, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Urtecho
authors.forename: Meredith
authors.initials: M
authors.lastname: Snapp
authors.forename: Michael
authors.initials: M
authors.lastname: Sperling
authors.forename: Mitchell
authors.initials: M
authors.lastname: Maltenfort
authors.forename: Matthew
authors.initials: M
authors.lastname: Vibbert
authors.forename: M Kamran
authors.initials: MK
authors.lastname: Athar
authors.forename: William
authors.initials: W
authors.lastname: McBride
authors.forename: Michael
authors.initials: M
authors.lastname: Moussouttas
authors.forename: Rodney
authors.initials: R
authors.lastname: Bell
authors.forename: Jack
authors.initials: J
authors.lastname: Jallo
authors.forename: Fred
authors.initials: F
authors.lastname: Rincon
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006402:Hematologic Diseases / Q000453:epidemiology; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D008107:Liver Diseases / Q000453:epidemiology; D008297:Male; D008659:Metabolic Diseases / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D009422:Nervous System Diseases / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data*; D015995:Prevalence; D044469:Racial Groups / Q000706:statistics & numerical data; D012140:Respiratory Tract Diseases / Q000453:epidemiology; D019035:Rural Health Services / Q000706:statistics & numerical data; D018805:Sepsis / Q000401:mortality*; D017678:Sex Distribution; D013226:Status Epilepticus / Q000401:mortality*; D014481:United States / Q000453:epidemiology; D016270:United States Agency for Healthcare Research and Quality; D019037:Urban Health Services / Q000706:statistics & numerical data