title: Single Center Outcomes of Status Epilepticus at a Paediatric Intensive Care Unit.
abstract: BACKGROUND
  Status epilepticus (SE) is a frequent admission diagnosis to paediatric intensive care units (PICUs) and is associated with variable outcomes. We have audited our experience of patients presenting in SE at a Canadian PICU to determine unfavorable outcome variables.
  
  
  METHODS
  Charts of patients <18 years of age presenting in SE to a tertiary care PICU over a 10-year period were audited. Data were analyzed at three care-points: transport, the emergency department (ED) and the PICU. Patient outcome before PICU discharge was categorized as "favorable" for return to pre-status functioning level or "unfavorable" for new deficit/death. Student's t-test and the Kruskal-Wallis test were used for analysis of normal and skewed continuous variables, respectively, and either Chi-square test or Fisher's exact test for categorical variables.
  
  
  RESULTS
  189 patients (54% males) were identified with a median age of 1.9 years. Idiopathic SE had the highest incidence; infectious/vascular etiologies were associated with more unfavorable outcomes. Progression to refractory SE in the ED had a higher incidence of death (p<0.05). Patients with an unfavorable outcome had a higher incidence of apnea during transport (p=0.01), longer hospital stays (p<0.05), need for therapeutic coma (p=0.01), longer duration of therapeutic coma (p<0.05), need for mechanical ventilation (p<0.05), and recurrent or refractory seizures during inpatient stay (p<0.05). Multivariate analysis of unfavorable outcomes of patients in SE presenting to the PICU included renal failure, cerebral edema, apnea during transport, refractory seizures, and recurrent seizures.
  
  
  CONCLUSIONS
  Refractory seizures in children presenting with SE are associated with worsened outcomes in the PICU.
authors.affiliation: 1Departments of Paediatric Critical Care Medicine,University of Tennessee Health Science Center and Le Bonheur Children's Hospital,Memphis,TN,USA.
authors.forename: Samir
authors.initials: S
authors.lastname: Shah
authors.affiliation: 2Paediatric Neurology,University of Tennessee Health Science Center and Le Bonheur Children's Hospital,Memphis,TN,USA.
authors.forename: Namrata
authors.initials: N
authors.lastname: Shah
authors.affiliation: 3Department of Family Medicine,University of Manitoba,Winnipeg,MB.
authors.forename: Robert
authors.initials: R
authors.lastname: Johnson
authors.affiliation: 1Departments of Paediatric Critical Care Medicine,University of Tennessee Health Science Center and Le Bonheur Children's Hospital,Memphis,TN,USA.
authors.forename: Alina Nico
authors.initials: AN
authors.lastname: West
authors.affiliation: 4Department of Clinical Neurosciences,Schulich School of Medicine and Dentistry,Children's Hospital at London Health Sciences Centre,London,ON,Canada.
authors.forename: Narayan
authors.initials: N
authors.lastname: Prasad
mesh_terms: D000293:Adolescent; D002170:Canada; D002648:Child; D002675:Child, Preschool; D054869:Clinical Audit; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D008297:Male; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D013226:Status Epilepticus / Q000628:therapy*; D014187:Transportation of Patients / Q000706:statistics & numerical data*