TY  - JOUR
AU  - Kohle, Felix
AU  - Madlener, Marie
AU  - Bruno, Emanuel F.
AU  - Fink, Gereon R.
AU  - Limmroth, Volker
AU  - Burghaus, Lothar
AU  - Malter, Michael P.
TI  - Status epilepticus and benzodiazepine treatment: Use, underdosing and outcome - insights from a retrospective, multicentre registry
JO  - Seizure
VL  - 107
SN  - 1059-1311
CY  - Oxford [u.a.]
PB  - Elsevier
M1  - FZJ-2023-02152
SP  - 114 - 120
PY  - 2023
AB  - Objective: To explore the reasons for and outcomes of non- or undertreatment with benzodiazepines (BZDs) in status epilepticus (SE).Methods: We retrospectively analysed all SE patients from the urban area of Cologne over two years.Results: 328 SE patients were eligible, and only 72% were initially treated with BZDs. Of these, only 21.6% were treated sufficiently with BZDs according to current guidelines. SE patients not initially treated with BZDs were significantly older, had less often known epilepsy, had a prolonged arrival time to the emergency room, and presented more often with a non-generalised convulsive semiology. Regarding adequate dosages, patients with a generalised convulsive SE seemed to benefit from a sufficient BZD dosing with significantly shortened mean ventilation duration (37.1 to 208 h), decreased mean intensive care unit (1.7 to 5 days) and in-hospital stay (4.1 to 8.8 days). In contrary, aggressive BZD treatment in non-generalised convulsive SE resulted in a longer inpatient stay (9.2 to 5.8 days) and lower favourable outcome rates at discharge (16% to 63%).Conclusions: The current SE treatment guidelines for first-line BZD therapy in SE were violated in most patients. Sufficient BZD dosing was beneficial in generalised convulsive SE, but not in other forms of SE. SE semiology might be crucial for treatment decisions with BZDs. Further treatment evidence especially in non-generalised convulsive SE is urgently needed.Keywords: Anticonvulsants; Benzodiazepines; Critical care; Guideline adherence; Seizures.
LB  - PUB:(DE-HGF)16
C6  - 37004393
UR  - <Go to ISI:>//WOS:001031705300001
DO  - DOI:10.1016/j.seizure.2023.03.020
UR  - https://juser.fz-juelich.de/record/1007669
ER  -