Generalized convulsive status epilepticus after nontraumatic subarachnoid hemorrhage: The Nationwide Inpatient Sample

Jan Claassen, Brian T. Bateman, Joshua Z. Willey, Sarah Inati, Lawrence J. Hirsch, Stephan A. Mayer, Ralph L Sacco, H. Christian Schumacher

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

OBJECTIVE: To identify the frequency of and impact on outcome of generalized convulsive status epilepticus (GCSE) among patients with nontraumatic subarachnoid hemorrhage (SAH). METHODS: We used the Nationwide Inpatient Sample, a database of admissions to nonfederal United States hospitals between 1994 and 2002, for this study. From this database, we identified all adult patients with nontraumatic SAH who were admitted through the emergency department. Independent predictors of GCSE and mortality were identified using multivariate logistic regression. Multivariate linear regression analysis was used to determine whether GCSE was independently associated with increased cost and/or duration of hospitalization. RESULTS: Among the 29,998 patients hospitalized with nontraumatic SAH, GCSE was reported to occur in 0.2% of patients (N = 73 patients). GCSE occurred more frequently among those in the youngest tertiale (49 years old or younger; odds ratio, 3.2; 95% confidence interval, 2.0-5.1), those with renal disease (odds ratio, 4.8; 95% confidence interval, 2.6-8.8), and those who did not undergo a neurosurgical procedure involving a craniotomy (odds ratio, 2.2; 95% confidence interval, 1.3-3.8). GCSE was independently associated with higher in-hospital mortality (48% versus 33% of patients; odds ratio, 2.1; 95% confidence interval, 1.3-3.4; P = 0.002) and longer (9 versus 7 days; P = 0.016) and more expensive (US $39,677 versus US $26,686; P = 0.007) hospitalizations. CONCLUSION: GCSE rarely complicates SAH; however, it is associated with increased patient mortality, length of hospital stay, and cost. GCSE occurs more frequently in young patients, those with a history of renal disease, and patients who do not undergo a craniotomy.

Original languageEnglish
Pages (from-to)60-64
Number of pages5
JournalNeurosurgery
Volume61
Issue number1
DOIs
StatePublished - Jul 1 2007
Externally publishedYes

Fingerprint

Status Epilepticus
Subarachnoid Hemorrhage
Inpatients
Odds Ratio
Confidence Intervals
Craniotomy
Length of Stay
Hospitalization
Databases
Neurosurgical Procedures
Kidney
State Hospitals
Mortality
Hospital Costs
Hospital Mortality
Hospital Emergency Service
Linear Models
Logistic Models
Regression Analysis
Costs and Cost Analysis

Keywords

  • Generalized convulsive status epilepticus
  • National inpatient sample
  • Seizures
  • Status epilepticus
  • Subarachnoid hemorrhage

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Claassen, J., Bateman, B. T., Willey, J. Z., Inati, S., Hirsch, L. J., Mayer, S. A., ... Schumacher, H. C. (2007). Generalized convulsive status epilepticus after nontraumatic subarachnoid hemorrhage: The Nationwide Inpatient Sample. Neurosurgery, 61(1), 60-64. https://doi.org/10.1227/01.neu.0000279724.05898.e7

Generalized convulsive status epilepticus after nontraumatic subarachnoid hemorrhage : The Nationwide Inpatient Sample. / Claassen, Jan; Bateman, Brian T.; Willey, Joshua Z.; Inati, Sarah; Hirsch, Lawrence J.; Mayer, Stephan A.; Sacco, Ralph L; Schumacher, H. Christian.

In: Neurosurgery, Vol. 61, No. 1, 01.07.2007, p. 60-64.

Research output: Contribution to journalArticle

Claassen, Jan ; Bateman, Brian T. ; Willey, Joshua Z. ; Inati, Sarah ; Hirsch, Lawrence J. ; Mayer, Stephan A. ; Sacco, Ralph L ; Schumacher, H. Christian. / Generalized convulsive status epilepticus after nontraumatic subarachnoid hemorrhage : The Nationwide Inpatient Sample. In: Neurosurgery. 2007 ; Vol. 61, No. 1. pp. 60-64.
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abstract = "OBJECTIVE: To identify the frequency of and impact on outcome of generalized convulsive status epilepticus (GCSE) among patients with nontraumatic subarachnoid hemorrhage (SAH). METHODS: We used the Nationwide Inpatient Sample, a database of admissions to nonfederal United States hospitals between 1994 and 2002, for this study. From this database, we identified all adult patients with nontraumatic SAH who were admitted through the emergency department. Independent predictors of GCSE and mortality were identified using multivariate logistic regression. Multivariate linear regression analysis was used to determine whether GCSE was independently associated with increased cost and/or duration of hospitalization. RESULTS: Among the 29,998 patients hospitalized with nontraumatic SAH, GCSE was reported to occur in 0.2{\%} of patients (N = 73 patients). GCSE occurred more frequently among those in the youngest tertiale (49 years old or younger; odds ratio, 3.2; 95{\%} confidence interval, 2.0-5.1), those with renal disease (odds ratio, 4.8; 95{\%} confidence interval, 2.6-8.8), and those who did not undergo a neurosurgical procedure involving a craniotomy (odds ratio, 2.2; 95{\%} confidence interval, 1.3-3.8). GCSE was independently associated with higher in-hospital mortality (48{\%} versus 33{\%} of patients; odds ratio, 2.1; 95{\%} confidence interval, 1.3-3.4; P = 0.002) and longer (9 versus 7 days; P = 0.016) and more expensive (US $39,677 versus US $26,686; P = 0.007) hospitalizations. CONCLUSION: GCSE rarely complicates SAH; however, it is associated with increased patient mortality, length of hospital stay, and cost. GCSE occurs more frequently in young patients, those with a history of renal disease, and patients who do not undergo a craniotomy.",
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