PMID- 31490288
OWN - NLM
STAT- MEDLINE
DCOM- 20200921
LR  - 20210208
IS  - 1537-1603 (Electronic)
IS  - 0736-0258 (Linking)
VI  - 37
IP  - 3
DP  - 2020 May
TI  - Towards Successes in the Management of Nonconvulsive Status Epilepticus: Tracing 
      the Detection-to-Needle Trajectories.
PG  - 253-258
LID - 10.1097/WNP.0000000000000630 [doi]
AB  - PURPOSE: Data on the timeliness of emergent medication delivery for nonconvulsive 
      status epilepticus (NCSE) are currently lacking. METHODS: Retrospective chart 
      reviews (between 2015 and 2018) and analyses of all patients with NCSE were 
      performed at the University of Nebraska Medical Center, a level 4 epilepsy 
      center, to determine the latencies to order and administration of the first, 
      second, and third antiepileptic drugs (AEDs). Recurrent NCSE cases were 
      considered independently and classified as comatose and noncomatose. RESULTS: 
      There were 77 occurrences of NCSE in 53 patients. The first, second, and third 
      AEDs were delivered with substantial delays at median times of 80 (25%-75% 
      interquartile range, 44-166), 126 (interquartile range, 67-239), and 158 minutes 
      (interquartile range, 89-295), respectively, from seizure detection. The median 
      times to the order of the first and second AEDs were 33 and 134.5 minutes longer 
      in comatose NCSE patients compared with those with noncomatose forms, 
      respectively (P = 0.001 and 0.004, respectively). The median times between the 
      AED orders and their administration in these two groups were the same (P = 0.60 
      and 0.37, respectively). With bivariate analysis, the median latencies to 
      administration of the first, second, and third AEDs were significantly increased 
      by 33, 109.5, and 173 minutes, respectively, in patients who died within 30 days 
      compared with those who survived (P = 0.047, P = 0.02, P = 0.0007, respectively). 
      CONCLUSIONS: The administration of the first, second, and third AEDs for NCSE was 
      delayed. Slow initiation of acute treatment in comatose patients was caused by 
      delays in the placement of the medication order.
FAU - Baang, Hae Young
AU  - Baang HY
AD  - Department of Neurological Sciences and.
FAU - Swingle, Nicholas
AU  - Swingle N
AD  - Department of Neurological Sciences and.
FAU - Sajja, Kalyan
AU  - Sajja K
AD  - Department of Neurological Sciences and.
FAU - Madhavan, Deepak
AU  - Madhavan D
AD  - Department of Neurological Sciences and.
FAU - Shostrom, Valerie K
AU  - Shostrom VK
AD  - Department of Biostatistics, University of Nebraska Medical Center, Omaha, 
      Nebraska, U.S.A.
FAU - Taraschenko, Olga
AU  - Taraschenko O
AD  - Department of Neurological Sciences and.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Clin Neurophysiol
JT  - Journal of clinical neurophysiology : official publication of the American 
      Electroencephalographic Society
JID - 8506708
RN  - 0 (Anticonvulsants)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anticonvulsants/*administration & dosage
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Seizures/drug therapy
MH  - Status Epilepticus/diagnosis/*drug therapy/mortality
MH  - Time-to-Treatment/*statistics & numerical data
EDAT- 2019/09/07 06:00
MHDA- 2020/09/22 06:00
CRDT- 2019/09/07 06:00
PHST- 2019/09/07 06:00 [pubmed]
PHST- 2020/09/22 06:00 [medline]
PHST- 2019/09/07 06:00 [entrez]
AID - 00004691-202005000-00013 [pii]
AID - 10.1097/WNP.0000000000000630 [doi]
PST - ppublish
SO  - J Clin Neurophysiol. 2020 May;37(3):253-258. doi: 10.1097/WNP.0000000000000630.