title: Role of comorbidities and in-hospital complications in short-term status epilepticus outcome.
abstract: OBJECTIVE
  pre-morbid patient conditions and hospitalization complications possibly play a role in status epilepticus short-term outcome, although evidence is incomplete and non-conclusive. The study's aim was to define whether comorbidities and in-hospital complications arising after status epilepticus affect its prognosis.
  
  
  METHODS
  A retrospective single center study was carried out. All selected patients were adults presenting an EEG-proven status epilepticus episode between 2003 and 2014. Medical charts were comprehensively reviewed. In-hospital mortality and length of hospital stay represented study outcomes.
  
  
  RESULTS
  One hundred seventy-three subjects met the inclusion criteria. Seventy-one cases (41%) developed infections and 59 (34%) non-infectious complications. Median hospital stay was 16days and overall in-hospital mortality was 44%. Multivariate analysis revealed the association between in-hospital mortality and the following comorbidities: history of diabetes mellitus (Odds ratio=7.89, p=0.002) and evidence of extracranial malignancy (Odds ratio=10.28, p=0.009). Complications were not associated to death after multivariate statistics, which instead displayed systemic inflammatory response syndrome significance (Odds ratio=12.90, p<0.001). Infections and non-infectious complications were associated with longer hospital stay (p=0.025 and p=0.01 respectively).
  
  
  CONCLUSIONS
  status epilepticus management is a multifaceted problem.
  
  
  RESULTS
  suggest that some pre-morbid patient conditions and in-hospital adverse events play an unfavorable prognostic role. This preliminary information may help clinicians optimize preventive and therapeutic strategies to guarantee patients the best chances of survival.
authors.affiliation: University of Trieste, Neurology Unit, Azienda ospedaliero-universitaria Ospedali Riuniti, Trieste, Italy. Electronic address: marco.belluzzo@hotmail.com.
authors.forename: Marco
authors.initials: M
authors.lastname: Belluzzo
authors.affiliation: University of Trieste, Neurology Unit, Azienda ospedaliero-universitaria Ospedali Riuniti, Trieste, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Furlanis
authors.affiliation: University of Trieste, Neurology Unit, Azienda ospedaliero-universitaria Ospedali Riuniti, Trieste, Italy.
authors.forename: Lara
authors.initials: L
authors.lastname: Stragapede
authors.affiliation: University of Trieste, Neurology Unit, Azienda ospedaliero-universitaria Ospedali Riuniti, Trieste, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Monti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000453:epidemiology; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D013226:Status Epilepticus / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality; D055815:Young Adult
keywords: Diabetes; EEG; Etiology; Modified Rankin scale; SIRS; Tumor