Time trends in incidence, mortality, and case-fatality after first episode of status epilepticus

Giancarlo Logroscino, Dale C. Hesdorffer, Gregory Cascino, John F. Annegers, W. Allen Hauser

Research output: Contribution to journalArticle

76 Scopus citations

Abstract

Purpose: Status epilepticus (SE) is a medical emergency associated with a high mortality. Clinical series have suggested that mortality after SE has decreased. No studies have systematically examined trends in incidence, mortality, and case fatality after SE in a well-defined population. Methods: All first episodes of SE receiving medical attention between January 1, 1935, and December 31, 1984, were ascertained through the Rochester Epidemiology Project Records-Linkage System and followed up until death or study termination (February 1, 1996). We calculated incidence rates in the 50-year period (1935-1984), while we considered mortality and case-fatality in the last 30-year period (1955-1984). Results: Incidence of SE increased over time to 18.1/100,000 (1975 through 1984). The increase was related to an increased incidence in the elderly and to the advent of myoclonic SE after cardiac arrest, a condition not seen in the early decades. In the last decade, ∼ 16% of the incidence was due to myoclonic SE. The mortality rates increased from 3.6 per year in the decade 1955-1965 to 4.0/100,000 per year between 1975 and 1984. The 30-day case-fatality (CF) was unchanged, although a trend toward improvement was shown after excluding myoclonic SE. Conclusions: Incidence and mortality rates of SE have increased in the last 30 years. Case fatality remained the same. The increased incidence and mortality are due to the occurrence in the last decade of myoclonic SE after cardiac arrest. The mortality in the elderly was twice that of the youngest age group, across all study periods. Changes in the age and cause distribution of SE over time are responsible for the stable survivorship. There is improvement in survivorship in the last decade when myoclonic SE is excluded.

Original languageEnglish (US)
Pages (from-to)1031-1035
Number of pages5
JournalEpilepsia
Volume42
Issue number8
DOIs
StatePublished - Sep 12 2001

Keywords

  • Case-fatality
  • Incidence
  • Mortality
  • Prognosis
  • Status epilepticus

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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