Abstract
Status epilepticus (SE) is a serious neurologic emergency associated with a significant mortality. The objective of this study is to investigate its epidemiology in terms of age- and sex-specific incidences and mortality. By using the Taiwan National Health Insurance Research Database during 2000 to 2011, we identified hospitalized patients with a discharged diagnosis of SE and calculated the incidence and in-hospital mortality of SE with respect to age and sex. The overall incidence of SE was 4.61 per 100,000 person-years, which displayed a “J-shaped” distribution by age with a little higher under the age of 5 and highest over 60 years. The male-to-female rate ratio was 1.57 and it demonstrated a “mountain-shape” across ages with the peak at 45 to 49 years old. The in-hospital mortality was significantly lower in males (7.38%) than in females (11.12%) with an odds ratio of 0.64 (95% CI 0.56-0.72). Notably, the in-hospital mortality for females increased rapidly after the age of 40 to 45 years. The multivariate analysis found males had a significantly lower risk of mortality than females after, but not before, 45 years of age with an odds ratio of 0.56 (95% CI 0.49-0.65). Sex and age are crucial factors associated with the incidence and in-hospital mortality of SE. The females over 45 years of age have a higher risk of occurrence and mortality from SE. The underlying mechanism deserves further study.
Highlights
Status epilepticus (SE) is a serious neurologic emergency and is often associated with significant mortality [1]
From 2000 to 2011, a total of 12,627 patients were identified with a first hospitalization for SE with an overall incidence of 4.61 per 100,000 person-years during the study period (Table 1)
We found that males have a significantly lower risk of mortality than females (OR = 0.64, 95% confidence intervals (95% CI) 0.56–0.72 in Table 3), which corroborates with the results of National Inpatient Sample databases in the United States [21]
Summary
Status epilepticus (SE) is a serious neurologic emergency and is often associated with significant mortality [1]. Epidemiology of Status Epilepticus in Taiwan encephalopathy (6% to 15%) and focal neurologic deficits (9% to 11%) [4,5]. Though there were some epidemiological studies examining SE [6,7,8,9,10,11,12,13,14], most of them were in Western countries, and very few studies were from Asian countries [15,16]. Some studies found males are more likely to suffer from SE than females [7,8,9]. The sex differences in SE occurrence and its mortality by age have not yet been well studied
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