Incidence of status epilepticus in adults in Germany: A prospective, population-based study

Purpose: To determine the incidence and case-fatality rate of status: epile pticus (SE) in adults in Hessen, Germany, we performed a prospective, popul ation-based study from July 1997 through June 1999. Methods: All adult patients residing within the zip-code area 35 (area-35) with SE were included. Area-35 had 743.285 adult inhabitants, including 123 .353 adult inhabitants of the primary service area of the University Hospit al Marburg (PS-area). Patients were reported by 16 hospitals in the area an d were prospectively identified and carefully reviewed within 5 days by one of the authors. Based on the crude annual incidence of SE and a rate of un derascertainment of 10% determined for the PS-area, the corrected, age-adju sted incidence of SE in area 35, more representative of the population of G ermany, was calculated. Results: The crude annual incidence in the PS-area was 15.8/100.000 [95% co nfidence interval(CI), 11.2-21.6]. The calculated, corrected, age-adjusted incidence of SE in area 35 was 17.1/100,000. It was higher for men compared with women (26.1 vs. 13.7) and for those aged 60 years and older (54.5 vs. 4.2/100,000, p < 0.0001). The etiology was mainly remote symptomatic due t o cerebrovascular disease. Epilepsy was previously diagnosed in only 50% of the patients. The case-fatality rate was 9.3%. Conclusions: Based on our data. at least 14,000 patients would be affected by SE in Germany, associated with <similar to>1,300 deaths annually. The in cidence of SE in Germany is similar to that found in the white United State s population. Furthermore, this study confirms the higher incidence of SE i n male patients and in the elderly population. This may be due to a higher incidence of cerebrovascular disease in these subpopulations.