Is Status Epilepticus Becoming More Frequent?

Andrea Rossetti, MD reviewing Betjemann JP et al. JAMA Neurol 2015 Jun 1.

A U.S. survey suggests that the diagnostic yield related to continuous electroencephalography has increased over time, while mortality remains relatively stable.

After stroke, status epilepticus (SE) is the most frequent neurological event with a potentially fatal outcome. Its definition and management have evolved to emphasize early treatment; in parallel, continuous video-electroencephalography (cEEG) monitoring is increasingly popular. In this study, researchers explored changes in SE hospitalization rates and mortality from 1999 through 2010 by analyzing discharge code data from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (NIS, covering approximately 20% of acute hospitalizations) and the Centers for Disease Control and Prevention (CDC) death certificates. They also assessed billing codes related to cEEG use.

During the period analyzed, yearly SE-related hospitalizations increased from 8.9 to 13.9 per 100,000 person-years (a 56% increase). The increase was greatest in patients with SE labeled as nonprincipal diagnosis (up 102%), especially in those who were also intubated (up 182%). In parallel, yearly age-standardized SE mortality increased only slightly, from 1.8 to 1.9 per 1,000,000 (6%), while cEEG billing increased substantially (from 1% to 4%).

Citation(s):

Betjemann JP et al. Trends in status epilepticus–related hospitalizations and mortality: Redefined in US practice over time. JAMA Neurol 2015 Jun 1; 72:650.