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Electrographic Seizures and Outcome in Critically Ill Children.

Authors :
Fung FW
Wang Z
Parikh DS
Jacobwitz M
Vala L
Donnelly M
Topjian AA
Xiao R
Abend NS
Source :
Neurology [Neurology] 2021 May 31; Vol. 96 (22), pp. e2749-e2760. Date of Electronic Publication: 2021 May 31.
Publication Year :
2021

Abstract

Objective: To determine the association between electroencephalographic seizure (ES) and electroencephalographic status epilepticus (ESE) exposure and unfavorable neurobehavioral outcomes in critically ill children with acute encephalopathy.<br />Methods: This was a prospective cohort study of acutely encephalopathic critically ill children undergoing continuous EEG monitoring (CEEG). ES exposure was assessed as (1) no ES/ESE, (2) ES, or (3) ESE. Outcomes assessed at discharge included the Glasgow Outcome Scale-Extended Pediatric Version (GOS-E-Peds), Pediatric Cerebral Performance Category (PCPC), and mortality. Unfavorable outcome was defined as a reduction in GOS-E-Peds or PCPC score from preadmission to discharge. Stepwise selection was used to generate multivariate logistic regression models that assessed associations between ES exposure and outcomes while adjusting for multiple other variables.<br />Results: Among 719 consecutive critically ill patients, there was no evidence of ES in 535 patients (74.4%), ES occurred in 140 patients (19.5%), and ESE in 44 patients (6.1%). The final multivariable logistic regression analyses included ES exposure, age dichotomized at 1 year, acute encephalopathy category, initial EEG background category, comatose at CEEG initiation, and Pediatric Index of Mortality 2 score. There was an association between ESE and unfavorable GOS-E-Peds (odds ratio 2.21, 95% confidence interval 1.07-4.54) and PCPC (odds ratio 2.17, 95% confidence interval 1.05-4.51) but not mortality. There was no association between ES and unfavorable outcome or mortality.<br />Conclusions: Among acutely encephalopathic critically ill children, there was an association between ESE and unfavorable neurobehavioral outcomes, but no association between ESE and mortality. ES exposure was not associated with unfavorable neurobehavioral outcomes or mortality.<br /> (© 2021 American Academy of Neurology.)

Details

Language :
English
ISSN :
1526-632X
Volume :
96
Issue :
22
Database :
MEDLINE
Journal :
Neurology
Publication Type :
Academic Journal
Accession number :
33893203
Full Text :
https://doi.org/10.1212/WNL.0000000000012032