title: Underestimated Rate of Status Epilepticus according to the Traditional Definition of Status Epilepticus.
abstract: OBJECTIVE
  Status epilepticus (SE) is an important neurological emergency. Early diagnosis could improve outcomes. Traditionally, SE is defined as seizures lasting at least 30 min or repeated seizures over 30 min without recovery of consciousness. Some specialists argued that the duration of seizures qualifying as SE should be shorter and the operational definition of SE was suggested. It is unclear whether physicians follow the operational definition. The objective of this study was to investigate whether the incidence of SE was underestimated and to investigate the underestimate rate.
  
  
  METHODS
  This retrospective study evaluates the difference in diagnosis of SE between operational definition and traditional definition of status epilepticus. Between July 1, 2012, and June 30, 2014, patients discharged with ICD-9 codes for epilepsy (345.X) in Chia-Yi Christian Hospital were included in the study. A seizure lasting at least 30 min or repeated seizures over 30 min without recovery of consciousness were considered SE according to the traditional definition of SE (TDSE). A seizure lasting between 5 and 30 min was considered SE according to the operational definition of SE (ODSE); it was defined as underestimated status epilepticus (UESE).
  
  
  RESULTS
  During a 2-year period, there were 256 episodes of seizures requiring hospital admission. Among the 256 episodes, 99 episodes lasted longer than 5 min, out of which 61 (61.6%) episodes persisted over 30 min (TDSE) and 38 (38.4%) episodes continued between 5 and 30 min (UESE). In the 38 episodes of seizure lasting 5 to 30 minutes, only one episode was previously discharged as SE (ICD-9-CM 345.3). Conclusion. We underestimated 37.4% of SE. Continuing education regarding the diagnosis and treatment of epilepsy is important for physicians.
authors.affiliation: Department of Neurology, Chia-Yi Christian Hospital, Chiayi, Taiwan ; Department of Nursing, Chung Jen Junior College of Nursing, Health Science and Management, Chiayi, Taiwan.
authors.forename: Cheung-Ter
authors.initials: CT
authors.lastname: Ong
authors.affiliation: Department of Family Medicine, Chia-Yi Christian Hospital, Chiayi, Taiwan.
authors.forename: Yi-Sin
authors.initials: YS
authors.lastname: Wong
authors.affiliation: Department of Neurology, Chia-Yi Christian Hospital, Chiayi, Taiwan.
authors.forename: Sheng-Feng
authors.initials: SF
authors.lastname: Sung
authors.affiliation: Department of Neurology, Chia-Yi Christian Hospital, Chiayi, Taiwan.
authors.forename: Chi-Shun
authors.initials: CS
authors.lastname: Wu
authors.affiliation: Department of Neurology, Chia-Yi Christian Hospital, Chiayi, Taiwan.
authors.forename: Yung-Chu
authors.initials: YC
authors.lastname: Hsu
authors.affiliation: Department of Neurology, Chia-Yi Christian Hospital, Chiayi, Taiwan.
authors.forename: Yu-Hsiang
authors.initials: YH
authors.lastname: Su
authors.affiliation: Department of Neurology, Chia-Yi Christian Hospital, Chiayi, Taiwan.
authors.forename: Ling-Chien
authors.initials: LC
authors.lastname: Hung
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012640:Seizures / Q000175:diagnosis; D013226:Status Epilepticus / Q000175:diagnosis* / Q000209:etiology; D055815:Young Adult