Abstract Details

Title Impact of Direct Outcome to a Comprehensive Epilepsy Center in Patients with Status Epilepticus

Topic Neuro Trauma and Critical Care

Presentation(s) P4 - Poster Session 4 (11:45 AM-12:45 PM)

Poster/Presentation
Number 2-001

Objective To determine if direct admission of status epilepticus (SE) patients to a comprehensive epilepsy center (CEC) is associated with improved outcome compared to admission to a community hospital with subsequent CEC transfer.

Background Immediate transfer to a specialized center is beneficial in acute stroke patients but it is not clear if that conveys any benefit to patients with other neurologic emergencies. We sought to compare the outcome of patients with SE directly admitted to a CSE with those undergoing transfer from community hospitals.

Design/Methods All patients admitted to a neurosciences ICU with SE were included in this observational study. A standardized data collection form was used to collect demographics, length of stay, mortality, in-hospital complications, discharge disposition, need for tracheostomy or percutaneous gastrostomy, and medications needed to terminate SE. Categorical variables were compared with Fisher’s exact test and continuous variables with t-test.

Results 110 patients were evaluated during a 2-year period; median age was 63 and 50% were males. Direct admission to the CEC occurred in 57(52%)-secondary transfer in 53(48%) patients. There was no difference in median age, race, or gender between groups. Similarly, there was no difference in the incidence of pneumonia, urinary infection, venous thromboembolism, kidney failure, tracheostomy/gastrostomy need, or death between groups ( P> 0.05 for all). Direct CES admission was associated with statistically significant decreased length of stay (17.64 days vs. 24. 08, p = 0.001) and with increased odds of home/acute rehabilitation at discharge (27/57 vs.14/53 p= 0.03 ). Transferred patients were more likely to need 2 or more anesthetic agents to abort SE ( 0.042).

Conclusions In this study SE patients admitted directly to a CES had significantly shorter length of stay, were more likely to be discharged to acute rehabilitation or home and required less anesthetic agents.

Authors/Disclosures
Julio A. Chalela, MD (Medical University of South Carolina) PRESENTER	Dr. Chalela has nothing to disclose.
Ron Neyens	No disclosure on file
Jimmy Suh, MD (MUSC)	Dr. Suh has received publishing royalties from a publication relating to health care.
Niren Kapoor, MD, PhD (Medical U of South Carolina-Dept of Neurosurgery)	Dr. Kapoor has nothing to disclose.
Charles Andrews (MUSC)	No disclosure on file

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