SHORT-TERM MORTALITY AFTER A FIRST EPISODE OF STATUS EPILEPTICUS

Purpose: Studies evaluating short-term mortality among people who expe rience status epilepticus (SE) have produced conflicting results. Most studies are derived from clinical series with results affected by uns pecified follow-up period and select referral of cases. This study was planned to evaluate short-term mortality after a first episode of SE. Methods: We performed a population-based retrospective cohort study t o determine the short-term mortality following a first episode of SE. Between January 1, 1965 and December 31, 1984, we studied all first ep isodes of afebrile SE who received medical attention in Rochester, Min nesota. Cases were followed until death or end of the study (February 1996). Results: Mortality within the first 30 days was 19% (38 deaths out of 201 incident SE). Thirty-four deaths (89%) occurred among those with nonfebrile acute symptomatic SE, while 4 deaths (11%) occurred a mong those with unprovoked SE. Within the acute symptomatic group, aft er adjusting for age, there was a decreased risk of death in women (RR = 0.4; 95% CI: 0.2-0.9). No effect of duration or seizure type was sh own after adjusting for other risk factors. Conclusions: One out of 5 subjects with SE died within the first 30 days. Short-term mortality i s associated with the presence of an underlying acute etiology. Among acute symptomatic cases, women had a decreased risk of dying.