Abstract Details

Title Co-Morbid Liver Dysfunction Correlates with Poor Prognosis in Partial and Generalized Status Epilepticus

Topic Epilepsy

Presentation(s) P03 - (-)

Poster/Presentation
Number 138

Objective

Background BACKGROUND: Although hepatic and renal failure are known to be associated with increased risk of isolated seizure activity, the prognostic relationship of these co-morbidities with partial or generalized status epilepticus has not been clearly established in the literature.

Design/Methods DESIGN/METHODS: Electronic medical records (EMR) and EEG recordings on 710 patients undergoing continuous EEG monitoring at The Methodist Hospital from January 2008 through January 2012 were reviewed and selected on the basis of having either partial or generalized status epilepticus by EEG criteria, ICD-9 codes, and EMR review to determine co-morbid illness. Prognosis at the time of discharge was classified with the Glasgow-Pittsburgh Cerebral Performance Category (CPC), dividing performance into five subsets, ranging from category 1: conscious and alert with normal cognitive function; to 5: certified brain death or death by traditional criteria. These CPC scores were compared with the control population (status epilepticus patients without concomitant organ dysfunction) using the Kruskal-Wallis test for statistical significance of ordinal data.

Results RESULTS: 51 patients were noted to be in partial status epilepticus, and 8 others developed generalized non-convulsive status epilepticus. Hepatic dysfunction in 7 patients (with and without renal insufficiency) correlated with poorer outcomes compared to controls. (median CPC = 5 (IQR: 5,5), mean = 4.71, compared with median CPC in controls = 2 (IQR: 2,3), mean = 2.38. [H=12.396, 1 d.f, P=0.00043, OR=34.8]). Subgroups with renal insufficiency (p=0.075) and/or heart failure (p=0.492) failed to achieve statistical significance (defined as p < 0.05).

Conclusions CONCLUSIONS: Cirrhosis and the hepatorenal syndrome correlate with poorer outcomes and death in status epilepticus patients.

Authors/Disclosures
Lukas T. Clark, MD (Saint Alphonsus Regional Medical Center) PRESENTER	No disclosure on file
Amit Verma, MD, MBBS, FAAN (The Methodist Neurological Institute)	No disclosure on file
Makoto Kawai, MD (The Stanford University, School of Medicine)	Dr. Kawai has nothing to disclose.
	No disclosure on file

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