Risk Factors of Prehospital Emergency Care for Acute Encephalopathy in Children With Febrile Status Epilepticus - 01/09/23
, Sotaro Kanai, MD, PhD, Yuko Nakamura, MD, Tatsuya Kawaguchi, MD, Kento Ohta, MD, Yoshihiro Maegaki, MD, PhDAbstract |
Background |
Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) often develops in children with febrile status epilepticus (FSE) with neurological sequelae. No study has investigated the associations between prehospital emergency care and AESD onset.
Methods |
We retrospectively collected the data of children with FSE (>30 min) treated in Tottori University Hospital. We evaluated the prehospital emergency care information, investigating its association with AESD development.
Results |
We identified 11 patients with AESD and 44 with FSE. The time from onset to the arrival of the emergency medical services (EMS) (OR: 1.12, P = 0.015) and hospital arrival (OR: 1.07, P = 0.009) was positively associated with AESD development. In contrast, oxygen saturation levels in ambulances (OR: 0.901, P = 0.013) are negatively associated with AESD development. The time from onset to arrival at the hospital was associated with the time from onset to the administration of antiseizure medications (ASMs) (correlation coefficient: 0.857, P < 0.001), which was significantly associated with AESD development (OR: 1.04, P = 0.039). The cutoff values were 17 minutes from onset to the arrival of EMS (OR: 27.2, P = 0.003), 38 minutes to hospital arrival (OR: 5.71, P = 0.020), and 50 minutes of administration of ASMs (OR: 7.11, P = 0.009).
Conclusions |
Prolonged time from onset to hospital arrival and hypoxia in ambulances were associated with AESD development. Shortening transport time, improving respiratory management in ambulances, and the early administration of ASMs might play a role in preventing the development of AESD.
Le texte complet de cet article est disponible en PDF.Keywords : Acute encephalopathy, Biphasic seizures, Diffusion, Prehospital emergency care, Status epilepticus
Plan
| Author contributions: T.O. was responsible for organizing and coordinating the trial, and Y.A. was the chief investigator responsible for data analysis. The trial was designed by S.K., Y.N., T.K., K.O., and Y.M. All authors contributed to the writing of the final manuscript, and all the authors met the ICMJE authorship criteria. |
Vol 147
P. 95-100 - octobre 2023 Retour au numéro
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