title: Infections in status epilepticus: a retrospective 5-year cohort study.
abstract: OBJECTIVE
  Status epilepticus (SE) has attracted renewed interest lately, and efforts are made to optimize every treatment stage. For refractory SE, optimal supporting care involves mechanical ventilation and intensive care unit (ICU) admission. Infections often complicate SE and recently a single-centre observational study demonstrated an association between infections and poor short-term outcome of SE in a cohort of severely ill patients. We have here attempted to replicate those findings in a different cohort.
  
  
  METHODS
  We performed a retrospective observational study and included all patients with a diagnosis of SE during 2008-2012 at a Swedish tertiary referral centre.
  
  
  RESULTS
  The cohort consisted of 103 patients (53% female, 47% male, median age 62 years, range 19-87 years). In house mortality was less than 2 and 70% of the patients' were discharged home. The most common aetiologies of SE were uncontrolled epilepsy (37%) and brain tumours (16%). A total of 39 patients suffered infections during their stay. Presence of infection was associated with mechanical ventilation (OR 3.344, 95% CI 1.44-7.79) as well as not being discharged home (OR2.705, 95% CI 1.14-6.44), and duration of SE was significantly longer in patients with infection (median 1 day vs. 2.5 days, p<0.001).
  
  
  CONCLUSIONS
  We conclude that the previously described association between infections, a longer SE duration, and an unfavourable outcome of SE seems valid also in SE of less severe aetiology.
authors.affiliation: Uppsala University, Department of Neuroscience, Neurology, 75185 Uppsala, Sweden. Electronic address: johan.zelano@neuro.uu.se.
authors.forename: Johan
authors.initials: J
authors.lastname: Zelano
authors.affiliation: Uppsala University, Department of Neuroscience, Neurology, 75185 Uppsala, Sweden.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Möller
authors.affiliation: Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University Salzburg, Austria.
authors.forename: Judith
authors.initials: J
authors.lastname: Dobesberger
authors.affiliation: Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University Salzburg, Austria.
authors.forename: Eugen
authors.initials: E
authors.lastname: Trinka
authors.affiliation: Uppsala University, Department of Neuroscience, Neurology, 75185 Uppsala, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Kumlien
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000150:complications; D015331:Cohort Studies; D004827:Epilepsy / Q000150:complications; D005260:Female; D006801:Humans; D015994:Incidence; D007239:Infections / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000009:adverse effects; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013226:Status Epilepticus / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D013548:Sweden / Q000453:epidemiology; D062606:Tertiary Care Centers; D013997:Time Factors; D055815:Young Adult
keywords: ICU; Infection; Status epilepticus