Helsinki University Research Articles

Reflections on the internationalization and regionalization of criminal policy – towards global views of criminal law theory

ABSTRACT The introductory article of Raimo Lahti starts with the description of Finnish–Chinese colloquia on criminal law 2016–2022, i.e. the cooperation in criminal sciences between the Peking University and the University of Helsinki. The author continues with the analysis of trends towards internationalization and regionalization of criminal policy and criminal justice – more generally, towards global law. The need of comparative criminal law is emphasized. The author's examples are mostly from the Nordic countries and Finland. He also prioritizes the examination of criminal law theory in transition and invites to express global views on criminal law theory.

Frontal Sinus Balloon Sinuplasty-Patient Satisfaction and Factors Predicting Reoperation.

To explore predictive factors of postoperative outcome of frontal sinus balloon dilation. Retrospective questionnaire study. Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Finland. We reviewed electronic records of all patients who underwent frontal sinus balloon dilatation (successful or attempted) in our clinic from 2008 to 2019. We documented patient characteristics, preoperative imaging results, intraoperative factors, possible complications, and reoperations. Those who underwent frontal sinus balloon sinuplasty were sent a questionnaire regarding their current symptoms and long-term satisfaction with surgery. In total, 258 operations (404 frontal sinuses) were reviewed, with a technical success rate of 93.6% (n = 378). The revision rate was 15.7% (n = 38). Previous sinonasal surgery predicted a higher revision rate (p = .004, odds ratio [OR] = 3.03, 95% confidence interval [CI] 1.40-6.56). Patients with hybrid surgery had significantly fewer reoperations compared to the balloon only group (p = .002, OR = 0.33, 95% CI 0.16-0.67). The response rate of the questionnaire was 64.5% (n = 156), of which 88.5% (n = 138) reported a long-term benefit from the balloon sinuplasty. Patient satisfaction was higher (p = .02, OR = 8.26, 95% CI 1.06-64.24) among patients using nasal corticosteroids. Technical success rate and patient satisfaction after frontal sinus balloon sinuplasty are high. Balloon sinuplasty seems insufficient in reoperations. A hybrid approach appears to result in fewer reoperations than a balloon only approach.

Farewell to Imagined Post-Sovietness. Is it Still Justified to Use the Term ‘Post-Soviet’?

Extract from a discussion, organised by AREI, held on 27 October 2022 at the University of Helsinki as part of the 21st Annual Aleksanteri Conference, “The New Era of Insecurity: How Russia’s War in Ukraine Changes the World”.

Bovine pericardial patch - a good alternative in femoral angioplasty.

Bovine pericardial patch (BPP) is currently used in femoral angioplasty as an alternative for autologous vein patch (AVP), but studies comparing the results of the two methods are scarce. In this retrospective study, we aimed to discover the differences between BPP and AVP closure in long-term durability. This study consisted of all femoral endarterectomies with BPP closure performed in Helsinki University Hospital from January 1, 2014, to December 31, 2017. For comparison, the same number of consecutive patients who underwent femoral endarterectomy with AVP closure from January 1, 2014, to October 16, 2016, were reviewed. Follow-up ended December 31, 2020. The mean follow-up was 19months (range, 0-74months) in the BPP group and 22months (range, 0-79months) in the AVP group. The primary endpoint was primary patency. Secondary endpoints were restenosis at patch site detected by imaging or perioperatively, patch rupture, and deep surgical wound infection. Propensity score analysis was performed for adjustment of differences between the AVP and BPP groups. Overall primary patency was superior in the AVP group compared with the BPP group: at 1year, 96.5% vs 85.0% and at 5years, 83.0% vs 72.3% (P= .04). In propensity score-matched pairs (n= 92), no difference was found between the groups in primary patency: 95.7% and 95.7% at 1year and 92.5% and 78.6% at 5years (P= .861) or in freedom from restenosis: 100% and 100% at 1year and 89.1% and 84.0% at 5years (P= .057). Deep wound infections occurred slightly more often after BPP closure (8%) than after AVP closure (4%), but the difference was not statistically significant (P= .144). There were no patch ruptures in the BPP group, but in the AVP group, there were five ruptures (3.5%) (P= .024). BPP is compatible to AVP in femoral endarterectomy in patency and can be regarded as the safer choice considering the risk of patch rupture.

Incidence and outcome of hospital-acquired COVID-19 infections in secondary and tertiary care hospitals in the era of COVID-19 vaccinations.

Hospital-acquired (HA) COVID-19 infections are known to increase morbidity and mortality. The aim of this study was to investigate the incidence and outcome of HA COVID-19 in different specialties across the wards in 18 hospitals belonging to the Helsinki University Hospital (HUH) responsible for secondary and tertiary care of a population of 1.8 million. Retrospective population-based cohort study. Secondary and tertiary care hospitals. Inpatients with HA COVID-19 infection. The HA COVID-19 infections with patient characteristics were retrospectively searched from HUH patient database from 1st October 2021 to 31st March 2022. All positive SARS-CoV-2 nucleic acid amplification tests (NAATs) from any ward were reviewed. The COVID-19 infection was classified as HA if a notification of HA infection was done or SARS-CoV-2 NAAT was positive ≥6 days after hospital admission or medical records revealed a known exposure for COVID-19 during hospital stay. 177 HA COVID-19 infections were retrieved with an incidence of 0.55 per 1000 patient days. Of these patients, 71 (40%) were treated in medicine, 52 (29%) in operative, and 54 (31%) in psychiatric wards, leading to incidences of 0.51, 0.39, and 1.10 per 1,000 patient days, respectively. In association with COVID-19, 16 (23%) in medicine, 3 (6%) in operative, and 1 (2%) patient in psychiatric wards deceased. Of the deceased patients, 16 (80%) had received at least one COVID-19 vaccine. Hospital-acquired COVID-19 infections in omicron era were related to high mortality, especially among patients in medicine wards who also had good vaccination coverage.

Glioma features and seizure control during long-term follow-up.

An epileptic seizure is a common presenting symptom of glioma, or epilepsy may develop later during the disease. Epileptic seizures affect the quality of life in patients with glioma. Good seizure control during 6-12months follow-up has been associated with gross total resection, radiation therapy and chemotherapy of gliomas. Little is known about seizure control during long-term follow-up and about factors which may affect the prognosis of epilepsy in glioma patients. We identified retrospectively all adult patients with diffuse glioma (grade 2-4) associated epilepsy (n=123) living in Helsinki, who received treatment at Helsinki University Hospital neuro-oncology center during 2013-2015. We excluded patients with histopathological diagnosis prior to 2005. Data was collected from medical records for five years after diagnosis of glioma, or until death. In this patient cohort 49 (39.8%) had grade 2 glioma, 19 (15.4%) had grade 3 glioma and 55 (44.7%) had grade 4 glioma. 29 (23.6%) of tumors were astrocytomas, 24 (19.5%) were oligoastrocytomas, 15 (12.2%) were oligodendrogliomas and 55 (44.7%) were glioblastomas. A seizure was the presenting symptom in 87 (70.7%) of the patients. The majority, 68 (57.6%) patients were seizure-free for at least 12months at some point during follow-up and 47 (39.8%) patients were seizure-free during the last year of follow-up. Survival for five years from glioma diagnosis (p<0.001), lower grade of tumor (p<0.001), IDH mutation (p<0.001), epilepsy as first symptom (p<0.001), younger age (p<0.001) and lack of progression (p = 0.021) correlated with seizure freedom at the end of follow-up. When the results were analyzed separately in survivors and deceased patients, only progression correlated negatively with seizure freedom at the end of follow-up in surviving patients (p = 0.008). In 5-year survivors, longer seizure-free periods were achieved by patients without progression of glioma (p = 0.040) vs patients with progression, or without focal aware (p 0.003) or focal impaired awareness seizures (p = 0.002) vs patients with only focal to bilateral tonic-clonic seizures. In deceased patients, progression (p<0.001) and lower grade of glioma (p = 0.003) correlated positively and focal aware seizures negatively (p = 0.021) with a longer seizure-free period. In all patients, freedom of seizures at the end of follow-up was less likely for patients who had focal aware (p = 0.015) than for patients without focal aware seizures. There are differences in seizure-free times in patients with grade 2-4 glioma and epilepsy. The results suggest that the prognosis of glioma may be the most important factor influencing the prognosis of epilepsy.

The hands-on learning of practical photogrammetry for archaeology

Photogrammetric techniques have been applied in archaeology for over 140 years, but recently, automation in software has significantly increased the popularity of photogrammetry. In 2018, the Master’s Programme in Cultural Heritage at Helsinki University arranged a special intensive hands-on course on geodesy, photogrammetry and laser scanning in Greece in order to provide more in-depth practical skills to students in an inspiring environment. The course was established in co-operation with Aalto University and the Finnish Institute at Athens. In this article, we describe how practical photogrammetry can be learned on an intensive hands-on course. Hands-on experiences and experimental learning enable good practical skills and also a deeper connection and understanding of theory. We believe that the students on the course managed to add photogrammetry to their archaeological toolboxes for the rest of their careers.

A Collaboration for Guiding the Rational Design of Multielement Solid Catalysts

AbstractThis invited Team Profile was created by the Inorganic Chemistry and Catalysis group, Department of Chemistry, University of Utrecht, the Netherlands; X‐ray Laboratory, Department of Physics, University of Helsinki, Finland; Laboratory of Inorganic Chemistry, Department of Chemistry and Applied Biosciences, ETH Zürich, Switzerland; Center for Materials Science and Nanotechnology, Department of Physics, University of Oslo, Norway; and Catalysis Research Center, Department of Chemistry, University of Oslo, Norway. They recently published an article on their successfully designed laboratory‐based setup enabling operando multi‐edge X‐ray absorption near‐edge structure (XANES), which offers possibilities for advanced catalyst characterization, as demonstrated for mono‐, bi‐, and trimetallic CO2 hydrogenation catalysts consisting of Ni, Cu, and Fe. Synergistic effects during catalyst reduction and their influence on catalytic performance were unravelled, guiding rational design of multielement solid catalysts for various applications. “Operando Laboratory‐based Multi‐edge X‐ray Absorption Near‐Edge Spectroscopy of Solid Catalysts”, N. S. Genz, A.‐J. Kallio, R. Oord, F. Krumeich, A. Pokle, Ø. Prytz, U. Olsbye, F. Meirer, S. Huotari, B. M. Weckhuysen, Angew. Chem. Int. Ed. 2022, e202209334; Angew. Chem. 2022, e202209334.

Buprenorphine‐naloxone, buprenorphine, and methadone throughout pregnancy in maternal opioid use disorder

Current WHO guidelines recommend using methadone or buprenorphine as maintenance treatments for maternal opioid use disorder. However, buprenorphine-naloxone, with a lower abuse risk than buprenorphine monotherapy or methadone, offers a potentially beneficial alternative, but scientific evidence on its effects on pregnancies, fetuses, and newborns is scarce. This paper compares the outcomes of the pregnancies, deliveries, and newborns of women on buprenorphine-naloxone, buprenorphine, or methadone maintenance treatments. According to the hypothesis, as a maintenance treatment, buprenorphine-naloxone does not have more adverse effects than buprenorphine, whereas methadone is more complicated. In this population-based study, 172 pregnant women on medical-assisted treatments were followed-up at Helsinki University Women's Hospital (Finland). Women receiving the same opioid maintenance treatment from conception to delivery and their newborns were included. Consequently, 67 mother-child dyads met the final inclusion criteria. They were divided into three groups based on their opioid pharmacotherapy. The outcomes were compared among the groups and, where applicable, with the Finnish population. The buprenorphine-naloxone and buprenorphine groups showed similar outcomes and did not significantly differ from each other in terms of maternal health during pregnancies, deliveries, or newborns. Illicit drug use during the pregnancy was common in all groups, but in the methadone group it was most common (p=0.001). Most neonates (96%) were born full-term with good Apgar scores. They were of relatively small birth size, with those in the methadone group tending to be the smallest. Of the neonates 63% needed pharmacological treatment for neonatal opioid withdrawal syndrome. The need was lower in the buprenorphine-based groups than in the methadone group (p=0.029). Buprenorphine-naloxone seems to be as safe for pharmacotherapy for maternal opioid use disorder as buprenorphine monotherapy for both mother and newborn. Hence it could be a choice for oral opioid maintenance treatment during pregnancy, but larger studies are needed before changing the official recommendations. Women on methadone treatment carry multifactorial risks and require particularly cautious follow up. Furthermore, illicit drug use is common in all treatment groups and needs to be considered for all patients with opioid use disorder.

Early clinical features of new-onset refractory status epilepticus (NORSE) in adults

BackgroundThe aim of this study was to identify early clinical features of patients with new-onset refractory status epilepticus (NORSE) that could direct the treatment in the first days of hospitalisation.MethodsA retrospective cohort study of adult NORSE patients treated in the intensive care units of Helsinki University Hospital 2007-2018.ResultsWe found 19 adult NORSE patients who divided into three subgroups on the basis of their clinical features: viral encephalitis (n = 5, 26%), febrile infection-related epilepsy syndrome (FIRES) (n = 6, 32%) and afebrile NORSE (n = 8, 42%). FIRES and afebrile NORSE patients remained without confirmed etiology, but retrospectively two paraneoplastic and two neurodegenerative causes were suspected in the afebrile NORSE group.Viral encephalitis patients were median 64 years old (IQR 55-64), and four (80%) had prodromal fever and abnormal findings in the first brain imaging. FIRES patients were median 21 years old (IQR 19-24), all febrile and had normal brain imaging at onset. In the afebrile NORSE group, median age was 67 (IQR 59-71) and 50% had prodromal cognitive or psychiatric symptoms. FIRES patients differed from other NORSE patients by younger age (p = 0.001), respiratory prodromal symptoms (p = 0.004), normal brain MRI (p = 0.044) and lack of comorbidities (p = 0.011). They needed more antiseizure medications (p = 0.001) and anesthetics (p = 0.002), had a longer hospital stay (p = 0.017) and more complications (p < 0.001).ConclusionsAmong febrile NORSE patients, FIRES group was distinctive due to patients’ young age, prodromal respiratory symptoms and normal first brain imaging. These features should be confirmed by subsequent studies as basis for selecting patients for early intensive immunotherapy.

Studies on migration in Europe: paths to think about languages, media, and journalism

From the point of view of researcher and journalist Tom Moring, Emeritus Professor at the Swedish School of Social Sciences at the University of Helsinki, this interview addresses how language and the social sharing of information impact in the integration process of refugees and migrants. Considering the researcher’s experience and his studies, the interview problematizes the media coverage and the work of journalists around these themes, highlights the connectivity of the variables migration, integration and information, and discusses how the results of European research in the area can be applied in diverse contexts, such as Latin America.

Mindfulness is associated with improved psychological well-being but no change in stress biomarkers in breast cancer survivors with depression: a single group clinical pilot study

BackgroundThe aim of this clinical single group pilot study was to assess mental well-being, psychological symptoms, and a set of stress biomarkers among breast cancer survivors with high depressive symptoms undergoing the Mindfulness-Based Stress Reduction (MBSR) program.MethodsParticipants included 23 curatively treated breast cancer survivors from the Helsinki University Central Hospital with clinically significant symptoms of depression (Beck Depression Inventory > 13, and assessed by a psychiatrist), at 1-year post-operative follow-up. Mental wellbeing and psychological symptoms were assessed with self-reported questionnaires (Resilience Scale, Self-Compassion Scale, Five Facet Mindfulness Questionnaire, World Health Organization Quality of Life-questionnaire, Perceived Stress Scale, Beck Depression Inventory, Beck Anxiety Inventory, Insomnia Severity Index); in addition, stress response was assessed with biomarkers (cortisol, adrenocorticotropine, and high-sensitivity-CRP from blood; 24 h-cortisol from urine). All measures were addressed at baseline, mid-program (4 weeks after baseline) and at the completion of the 8-week MBSR program. Engagement to the independent mindfulness home practice was collected with a diary.ResultsFrom baseline to the completion of the 8-week MBSR program, we observed significant increases in resilience (d = 0.60, p = 0.005), and quality of life (d = 0.92, p = 0.002), and significant reductions in symptoms of depression (d = − 1.17, p < 0.0001), anxiety (d = − 0.87, p < 0.0001), insomnia (d = − 0.58, p = 0.006), and marginally significant reduction in perceived stress (d = − 0.40, p = 0.09). We found no changes in self-compassion or mindfulness skills, nor in the stress biomarkers during or at the completion of the program. There was no association between the engagement time to the independent mindfulness practice and any of the outcomes.ConclusionsAttending the MBSR program was associated with increased wellbeing and reduced psychological symptoms in breast cancer survivors with clinically significant symptoms of depression. However, these favorably experienced changes did not transfer to the level of stress biomarkers during the 8-week program. Lack of association between the engagement in the mindfulness home practice and change in outcomes suggests that in the studied range of practice time, other qualities of MBSR despite the amount of independent practice may have a more important role for the improved wellbeing.Trial registration ISRCTN12326308 at 16/02/2021, retrospectively registered.

Is there a correlation between PhD students' outlooks on academic writing and their happiness, and how these attitudes are measured?

This study looked at how PhD students felt about writing and how well they thought they could write. The Writing Process Questionnaire was developed to gain a better understanding of the attitudes PhD students have toward academic writing. This survey's findings were examined to learn how PhD students view academic writing. It was fascinating to investigate whether there was a relationship between PhD students' views on writing and their mental health. This was another another intriguing feature of the study. A top institution in Finland recruited 669 PhD students who gave their time to answer a survey. The University of Helsinki is the institution in question. To create the sum variables for the current study, 26 questions were used. The six separate theoretical constructs that were created using these sum variables were then measured using different scales. The many structures that were on the table were referred to as blocks, procrastination, perfectionism, innate ability, knowledge transformation, and productivity.&#x0D; Production, overcoming obstacles, aiming for perfection, and an individual's innate potential are a few instances of these concepts. To confirm the six-dimensional theory, a confirmatory factor analysis, or CFA, was conducted. Exhaustion, stress, concern, and a general lack of interest are all positively correlated with perfectionism, procrastination, and obstructions, but negatively correlated with productivity. This is due to the positive correlations between perfectionism, procrastination, and obstructions and all of these factors except productivity. The six-factor structure of the writing scale, which assesses writing ability, was found to be valid through the use of LISREL in either confirmatory research or analysis. This made it possible to determine the scale's reliability. As a result, there is enough data to draw the conclusion that the questionnaire is a valid and reliable tool that can accurately capture a variety of key aspects of the academic writing process, including its emotional components. This conclusion can be drawn as a result of the fact that there is enough data to establish the validity and reliability of the questionnaire.

Sleep and psychiatric symptoms in young child psychiatric outpatients - a Follow-up study.

Knowledge of the continuity of sleep problems and the associations between sleep and psychiatric symptoms in child psychiatric patients is scarce. To investigate the persistency of sleep problems and how sleep at preschool age predicts sleep problems and psychiatric symptoms at school age in child psychiatric patients. Participants (n = 68) were child psychiatry outpatients at Helsinki University Hospital in 2015-2017. Caregivers evaluated sleep with the Sleep Disturbance Scale for Children (SDSC) and psychiatric symptoms with the Child Behavior Checklist (CBCL) at baseline (age 4-7years) and again at follow-up (age 8-13 years). Family background information was collected at both time points. Sleep problems at preschool age predicted sleep problems at school age (R2Adjusted = .48, p < .001). Persistent sleep problems associated strongly with the intensity of psychiatric symptoms (p = .001). Internalizing symptoms were predicted by sleep problems (p = .038) even after controlling for age, sex, and psychiatric symptoms at preschool age. Sleep problems are prevalent and persistent and relate to psychiatric symptoms in children treated at child psychiatry clinics. These results emphasize the need for identification and treatment of sleep problems in these children.

Impact of white matter hypodensities on outcome after intracerebral hemorrhage

ObjectivesWhite matter hypodensities (WMH), a surrogate of small vessel disease, associate with cognitive decline and stroke risk. The impact of WMH on functional outcome after intracerebral hemorrhage (ICH) has differed between studies. We aimed to examine factors associated with the severity of WMH in ICH, and whether there is an independent association between the extent of WMH and outcome. Materials and methodsThis was a prospective study of consented patients with non-traumatic primary ICH, admitted to the Helsinki University Hospital between May 2014 and December 2018. To evaluate the extent of the WMH, modified van Swieten score of the side contralateral to the ICH was obtained. Patients were grouped into 3 categories of the scores. We performed univariate and multivariable analyses to find out factors associated with the severity of WMH, and whether WMH associate with functional outcome and mortality up to 12 months, adjusted for the known major outcome predictors. ResultsIn our cohort of 417 ICH patients, WMH severity associated with older age, female sex, admission National Institutes of Health Stroke Scale (NIHSS) points, and signs of previous ischemic stroke on CT. We found an independent association between WMH severity and poor functional outcome at 3 months (OR 1.72, 95% CI 1.27-2.33), and 1 year (OR 2.16, 95% CI 1.57-2.95), and mortality at 1 year (OR 1.91, 95% CI 1.29-2.85). ConclusionsIn our ICH patients, vascular comorbidities and older age associated with the presence of WMH, which, in turn, strongly associated with poor functional outcome.

Dangerous Giving in Nineteenth-Century American Literature

Dangerous Giving in Nineteenth-Century American Literature

Määräyspatteristo vai krumeluuriteksti – kielipoliittiset dokumentit yliopistojen hallintohenkilöstön näkökulmasta

The paper focuses on language policies in two Nordic universities and the way in which administrative staff perceive the policies as instruments of language regulation. There has been much interest recently in multilingualism and language policy in the context of higher education, but there is little research so far focusing on administrative staff. This is despite their key role in both producing and mediating texts for the consumption of a multilingual university community. The study is based on interview and document data collected at the University of Helsinki (Finland) and the University of Stockholm (Sweden). The analysis focuses on how staff talk about the role of the policies in their work and work community, and particularly how they describe the impact of the policies on everyday language practices.

Keratitis fugax hereditaria ‐ useful to consider when you have a child with non‐specific corneal findings and symptoms

AbstractPurpose: To report clinical findings in children diagnosed with the autosomal dominant periodic corneal autoinflammation, keratitis fugax hereditaria (KFH, MIM 148200), and to highlight its geographical distribution.Methods: Patients were clinically examined in the Helsinki University Hospital between February 4, 2006, and December 31, 2021, and genetically verified to be carriers of the c.61G &gt; C (rs200154873) variant in NLRP3 by Sanger sequencing. Variant allele frequencies were determined from Genome Aggregation Database (gnomAD) version 2.1.1.Results: The data consist of 10 children from 8 families; 6 boys and 4 girls. Age of onset varied from 3 to 14 (median, 8) years. Patients had typical KFH symptoms: eye pain, photophobia, conjunctival injection, and foreign body sensation. Five patients had corneal oval opacities, and 3 had a mild anterior chamber reaction. Seven were correctly diagnosed at the first visit based on family history. The remaining three children were diagnosed 1, 3, and 8 years after the first visit. Initial diagnoses were anterior uveitis, corneal erosion, and herpetic keratitis. Additionally, epithelial recurrent erosion dystrophy (ERED) or subepithelial mucinous corneal dystrophy (SMCD) had been suspected. Geographically, KFH concentrates to the bilingual Swedish‐speaking coastal areas of Finland. Allele frequencies are 0.014% in Finland, and 0.011% in Sweden, based on gnomAD.Conclusions: Scandinavian ophthalmologists should be aware of the possibility of KFH in case of suspected anterior uveitis, herpetic keratitis, or recurrent corneal erosion in children. Symptoms of paediatric KFH patients are equal to those in adults, but the typical corneal opacity still might recover between the attacks.

RWD145 The Direct Cost Savings and Indirect Value of Using Artificial Intelligence With Clinical Disease Specific Quality Register Data - Case Helsinki University Eye Clinic: Cataract Register and Retina Register

RWD145 The Direct Cost Savings and Indirect Value of Using Artificial Intelligence With Clinical Disease Specific Quality Register Data - Case Helsinki University Eye Clinic: Cataract Register and Retina Register

Long-term outcome of convulsive status epilepticus: a 10-year follow-up

This study aimed to determine the mortality, causes of death and factors affecting the outcome of convulsive status epilepticus (CSE) at 10 years. This retrospective study consisted of 62 consecutive adult patients diagnosed with CSE at the Helsinki University Hospital (HUS) emergency department during 2002-2003. Patients were followed for up to 10 years or up to the time of death. Data on patient demographics, CSE characteristics, treatment, complications, and outcome from the time of CSE were collected. The Official Statistics of Finland provided the information on mortality and causes of death. Survival analysis was conducted using Cox proportional hazards regression analysis. In-hospital mortality was 8.1%, and mortality was 25.8% at one year, 51.6% at five years and 64.5% at 10 years. Estimated standardized mortality ratio (SMR) was 5.3 and the deceased patients lost 20.9 potential years of life, on average. The leading causes of death were disorders of the brain or the circulatory system, epilepsy-related conditions or intracranial tumours. The univariable survival analysis demonstrated that age ≥65 (HR=2.8, p=0.001), Charlson Comorbidity Index (CCI)>0 (CCI=1-3: HR=3.0, p=0.009; CCI>3: HR=8.4, p<0.001), Status Epilepticus Severity Score (STESS)>4 (HR=5.3, p<0.001) and Epidemiology-Based Mortality Score (EMSE-EAC)>15 (HR=2.2, p=0.036) were risk factors and a Glasgow outcome scale (GOS) of 5 at discharge (HR=0.14, p=0.025) was a protective factor for survival. The multivariable analysis established STESS>4 (HR=5.0, p=0.002) and CCI>0 (CCI=1-3: HR=2.9, p=0.015;CCI>3: HR=6.3, p=0.006) as independent risk factors and GOS>3 (time-dependent) (GOS=4: HR=0.33, p=0.048;GOS=5: HR=0.13, p=0.019) as a protective factor for survival. The rate of long-term mortality and number of potential years of life lost were high. Factors demonstrative of the overall situation of the patients, such as comorbidities, functional state after CSE and age, were significant predictors for long-term outcome.