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@ARTICLE{Kohle:1007669,
author = {Kohle, Felix and Madlener, Marie and Bruno, Emanuel F. and
Fink, Gereon R. and Limmroth, Volker and Burghaus, Lothar
and Malter, Michael P.},
title = {{S}tatus epilepticus and benzodiazepine treatment: {U}se,
underdosing and outcome - insights from a retrospective,
multicentre registry},
journal = {Seizure},
volume = {107},
issn = {1059-1311},
address = {Oxford [u.a.]},
publisher = {Elsevier},
reportid = {FZJ-2023-02152},
pages = {114 - 120},
year = {2023},
abstract = {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.},
cin = {INM-3},
ddc = {610},
cid = {I:(DE-Juel1)INM-3-20090406},
pnm = {5251 - Multilevel Brain Organization and Variability
(POF4-525)},
pid = {G:(DE-HGF)POF4-5251},
typ = {PUB:(DE-HGF)16},
pubmed = {37004393},
UT = {WOS:001031705300001},
doi = {10.1016/j.seizure.2023.03.020},
url = {https://juser.fz-juelich.de/record/1007669},
}