Estudio de variables demográficas, clínicas y pronósticas en adultos mayores con status epiléptico: análisis comparativo entre diferentes grupos etarios

Abstract

Introduction

Status epilepticus (SE) is a neurological emergency. Certain clinical features and personal patient history have prognostic utility and could contribute to therapeutic decision-making.

Objectives

To describe the demographic and clinical characteristics in patients ≥ 65 years divided into subgroups. To define predictive and prognostic variables.

Material and methods

A retrospective observational study was conducted on all cases of convulsive (CSE) and non-convulsive (NCSE) SE admitted to the Hospital Privado de Comunidad between 2006 and 2013. Age groups were subcategorized according to the World Health Organization (WHO): 65-74 years (G1), 75-84 years (G2), and ≥ 85 years (G3).

Results

A total of 289 patients with SE aged ≥ 65 years were recorded. 84 patients (29.1%) belonged to G1, 141 (48.8%) to G2, and 64 (22.1%) to G3. Females were the most prevalent gender. G3 had the lowest percentage of epilepsy history (9.4%). There was no difference in the CSE-vs-NCSE ratio between the groups. Cerebrovascular disease (CVD) was the most prevalent presentation in the groups, with a higher low-dose of antiepileptic drugs in G1 (P = .08). 30-day lethality was 46.8% (G3), 30.9% (G1), and 36.2% (G2) (P = .13). G1 patients had a higher recurrence rate (P = .001). The total hospitalization cost was higher for G1 (P = .005).

Conclusion

There is a trend to present SE as the first crisis in G3. SE in the elderly tends to occur without a history of epilepsy. The most frequent acute symptomatic cause is CVD. Age is a poor prognostic factor. Hence, the importance of this study in providing data related to this pathology in older adults.