To systematically review and evaluate the outcome of Status Epilepticus (SE) including mortality and functional outcomes in elderly population.

A systematic search was conducted of Cochrane, PubMed, CINAHL, and EMBASE electronic databases on April 19^th, 2018. Inclusion criteria were studies with clearly defined elderly population (≥ 60 year-old), number of patients ≥3, status epilepticus, and report of outcomes. Various outcomes including mortality, short-term, and long-term functional outcomes were collected.

2669 titles and abstracts were screened from the initial search after removal of duplicates. 431 full text articles were reviewed in detail, and 88 studies were included in the final review. Most studies were descriptive and did not report statistical significance for the outcomes. Mortality was reported in 67 studies among which 19 studies were statistically significant and 5 studies were not significant. Mortality was reported descriptively in the rest 37 studies.  “Good” and “poor” outcomes were reported in 28 studies out of which 7 studies showed significantly poor outcome and 1 study showed significantly good outcome in elderly compared to the younger population. Neurologic sequelae after SE were reported in 13 studies among which 2 studies were significant compared to non-elderly population. Functional outcomes including modified Rankin Scale (mRS) (N=8), Status Epilepticus Severity Score (N=7) and Glasgow Outcome Scale (N=2) were reported descriptively but did show worsening compared to either preadmission or younger population enrolled in studies.

This review provided preliminary evidence that SE in elderly results in increased mortality, unfavorable outcomes, and worsened functional outcomes. However, most studies were descriptive of their findings. Future studies with more detailed outcome measures and more use of statistical methods should be considered in this population.