Identification of Risk Factors for Refractory Status Epilepticus

2019 ◽  
Vol 54 (1) ◽  
pp. 14-21
Author(s):  
Hayley A. Tatro ◽  
Leslie A. Hamilton ◽  
Cassey Peters ◽  
A. Shaun Rowe
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Status Epilepticus ◽  
Refractory Status Epilepticus ◽  
Bivariate Analysis ◽  
Stepwise Logistic Regression ◽  
Retrospective Case ◽  
Lower Odds ◽  
Refractory Status ◽  
Convulsive Seizures

Objective: The objective of this study is to identify risk factors for the development of refractory status epilepticus (RSE). Methods: This was an IRB-approved, retrospective case control study that included patients admitted with status epilepticus between August 1, 2014, and July 31, 2017. Cases were defined as those with RSE, and controls were those who did not develop RSE. A bivariate analysis was conducted comparing those with RSE and those without RSE. A stepwise logistic regression model was constructed predicting for progression to RSE. Risk factors for progression to RSE were extrapolated from this model. Results: A total of 184 patients met inclusion criteria for the study (99 controls and 49 cases). After adjusting for covariates in the logistic regression, patients with convulsive seizures had a lower odds of developing RSE (odds ratio [OR] = 0.375; 95% CI = 0.148 to 0.951; P = 0.0388). Treatment with benzodiazepines plus levetiracetam had a higher odds of developing RSE (OR = 3.804; 95% CI = 1.523 to 9.499; P = 0.0042). Conclusion and Relevance: This study found that patients with convulsive seizures had a lower odds of developing RSE. In addition, patients treated with benzodiazepines and levetiracetam had a higher odds of developing RSE. This information can be used to potentially identify patients at higher risk of developing RSE, so that treatment can be modified to reduce morbidity and mortality. These results may warrant further investigation into the effectiveness of levetiracetam as a first-line agent for the treatment of SE.

De Novo Sustained Refractory Status Epilepticus and Encephalopathy: A Retrospective Case Series

2010 ◽  
Vol 25 (12) ◽  
pp. 1535-1538 ◽  
Author(s):  
Joanna S. Fong ◽  
Stephen Hantus ◽  
Ebru Erbayat Altay ◽  
Ingrid Tuxhorn
Keyword(s):  
Status Epilepticus ◽  
De Novo ◽  
Case Series ◽  
Refractory Status Epilepticus ◽  
Retrospective Case ◽  
Refractory Status ◽  
Retrospective Case Series

scholarly journals A Clinical Analysis of Two Cases of Refractory Status Epilepticus of Generalized Convulsive Seizures

2014 ◽  
Vol 0 (1S) ◽  
pp. 25 ◽  
Author(s):  
V. A. Karlov ◽  
I. A. Zhidkova ◽  
P. N. Vlasov ◽  
B. P. Gladov ◽  
O. A. Podgornaya ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Clinical Analysis ◽  
Refractory Status Epilepticus ◽  
Refractory Status ◽  
Convulsive Seizures

scholarly journals Influence of physical activity and postural habits in schoolchildren with scoliosis

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Sanderson José Costa de Assis ◽  
Geronimo José Bouzas Sanchis ◽  
Clécio Gabriel de Souza ◽  
Angelo Giuseppe Roncalli
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Logistic Regression ◽  
School Environment ◽  
Activity Index ◽  
Conditional Logistic Regression ◽  
Outcome Variable ◽  
Bivariate Analysis ◽  
Childhood And Adolescence ◽  
Retrospective Case

Abstract Background Scoliosis is considered one of the main musculoskeletal changes in childhood, and is characterized by three-dimensional changes in the spine. Schoolchildren is a group who are directly exposed to this condition because they go through a rapid growth phase in adolescence, added to other external factors such as school environment and daily living habits such as little physical activity. This study aimed to identify the risk factors associated with scoliosis in schoolchildren. Methods An observational, retrospective case control study with a quantitative approach was carried out in the city of Santa Cruz/RN. The presence of scoliosis was assessed using the Adams test and physical activity by the Daily Physical Activity Index (IPAQ) and by a questionnaire on competitive sports practice, in addition to a questionnaire on postural habits in childhood and adolescence. Conditional multiple logistic regression was performed for statistical analysis, and the adjusted Odds Ratios (OR) and the respective confidence intervals (95%) of the outcome variable were estimated. Results A total of 156 schoolchildren participated in the study, with an average age of 13.9 years, with 55.1% being female and 44.9% male, attending between the 6th grade of elementary school and the 3rd year of high school. Furthermore, 42.9% of these participants were considered irregularly active and only 33.3% practiced physical activity on a regular basis. After bivariate analysis and conditional logistic regression, little physical activity was shown to be a risk factor for scoliosis (p = 0.041; OR: 2.81; 95% CI: 1.04–7.57), while the postural habits evaluated in this study did not show a statistical association with scoliosis. Conclusion Low practice of physical activity and schoolchildren being classified as irregularly active were considered as risk factors for scoliosis, however postural habits do not seem to be associated with this condition.

scholarly journals Prediction of Endometrial Hyperplasia and Cancer among Premenopausal Women with Abnormal Uterine Bleeding

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Luca Giannella ◽  
Lillo Bruno Cerami ◽  
Tiziano Setti ◽  
Ezio Bergamini ◽  
Fausto Boselli
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Prediction Model ◽  
Endometrial Hyperplasia ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Stepwise Logistic Regression ◽  
Simultaneous Presence ◽  
Endometrial Pathology

Objective. To create a prediction model including clinical variables for the prediction of premalignant/malignant endometrial pathology in premenopausal women with abnormal uterine bleeding (AUB). Methods. This is an observational retrospective study including 240 premenopausal women with AUB referred to diagnostic hysteroscopy. Based on the presence of endometrial hyperplasia (EH) or cancer (EC), the women were divided into cases (EH/EC) and controls (no EH/EC). Univariate, stepwise logistic regression and ROC curve analysis were performed. Results. 12 women had EH/EC (5%). Stepwise logistic regression analysis showed that EH/EC associated significantly with BMI ≥ 30 (OR=7.70, 95% CI 1.90 to 31.17), diabetes (OR=9.71, 95% CI 1.63 to 57.81), and a thickened endometrium (OR=1.20, 95% CI 1.08 to 1.34, criterion > 11 mm). The AUC was 0.854 (95% confidence intervals 0.803 to 0.896, p<0.0001). Considering the pretest probability for EH/EC of 5%, the prediction model with a positive likelihood ratio of 8.14 showed a posttest probability of 30%. The simultaneous presence of two or three risk factors was significantly more common in women with EH/EC than controls (50% vs. 6.6 and 25% vs. 0%, respectively, p<0.0001). Conclusion. When premenopausal vaginal bleeding occurs in diabetic obese women with ET > 11 mm, the percentage of premalignant/malignant endometrial pathology increases by 25%. It is likely that the simultaneous presence of several risk factors is necessary to significantly increase the probability of endometrial pathology.

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