Impact of frailty, biomarkers and basic biochemical parameters on outcomes of comatose patients in status epilepticus: a single-center prospective pilot study
Jazyk angličtina Země Anglie, Velká Británie Médium electronic
Typ dokumentu časopisecké články
PubMed
38279084
PubMed Central
PMC10811840
DOI
10.1186/s12883-024-03537-y
PII: 10.1186/s12883-024-03537-y
Knihovny.cz E-zdroje
- Klíčová slova
- CFS, Frailty, Outcome, STESS, Score, Status epilepticus, mFI-11,
- MeSH
- biologické markery MeSH
- dospělí MeSH
- kojenec MeSH
- kóma diagnóza MeSH
- křehkost * MeSH
- lidé středního věku MeSH
- lidé MeSH
- pilotní projekty MeSH
- prognóza MeSH
- prospektivní studie MeSH
- retrospektivní studie MeSH
- senioři MeSH
- status epilepticus * diagnóza MeSH
- stupeň závažnosti nemoci MeSH
- troponin T MeSH
- Check Tag
- dospělí MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- biologické markery MeSH
- troponin T MeSH
BACKGROUND: Status epilepticus (SE) is a severe acute condition in neurocritical care with high mortality. Searching for risk factors affecting the prognosis in SE remains a significant issue. The primary study's aim was to test the predictive values of the Clinical Frailty Scale (CFS) and the Modified 11-item Frailty Index (mFI-11), the biomarkers and basic biochemical parameters collected at ICU on the Glasgow Outcome Scale (GOS) assessed at hospital discharge (hosp), and three months later (3 M), in comatose patients with SE. The secondary aim was to focus on the association between the patient's state at admission and the duration of mechanical ventilation, the ICU, and hospital stay. METHODS: In two years single-centre prospective pilot study enrolling 30 adult neurocritical care patients with SE classified as Convulsive SE, A.1 category according to the International League Against Epilepsy (ILAE) Task Force without an-/hypoxic encephalopathy, we evaluated predictive powers of CFS, mFI-11, admission Status Epilepticus Severity Score (STESS), serum protein S100, serum Troponin T and basic biochemical parameters on prognosticating GOS using univariate linear regression, logistic regression and Receiver Operating Characteristic (ROC) analysis. RESULTS: Our study included 60% males, with a mean age of 57 ± 16 years (44-68) and a mean BMI of 27 ± 5.6. We found CFS, mFI-11, STESS, and age statistically associated with GOS at hospital discharge and three months later. Among the biomarkers, serum troponin T level affected GOS hosp (p = 0.027). Serum C-reactive protein significance in prognosticating GOS was found by logistic regression (hosp p = 0.008; 3 M p = 0.004), and serum calcium by linear regression (hosp p = 0.028; 3 M p = 0.015). In relation to secondary outcomes, we found associations between the length of hospital stay and each of the following: age (p = 0.03), STESS (p = 0.009), and serum troponin T (p = 0.029) parameters. CONCLUSIONS: This pilot study found promising predictive powers of two frailty scores, namely CFS and mFI-11, which were comparable to age and STESS predictors regarding the GOS at hospital discharge and three months later in ICU patients with SE. Among biomarkers and biochemical parameters, only serum troponin T level affected GOS at hospital discharge.
Emergency Medical Services Klasterni 954 5 Liberec 460 01 Czech Republic
Neurocenter Neurointensive Care Unit Regional Hospital Husova 357 10 Liberec 46001 Czech Republic
University Hospital Kralovske Vinohrady 110 34 Prague 10 Srobarova 1050 Czech Republic
Zobrazit více v PubMed
Shorvon S, Sen A. What is status epilepticus and what do we know about its epidemiology? Seizure. 2020;75:131–6. doi: 10.1016/j.seizure.2019.10.003. PubMed DOI
Rossetti AO, Logroscino G, Milligan TA, Michaelides C, Ruffieux C, Bromfield EB. Status Epilepticus Severity score (STESS): a tool to orient early treatment strategy. J Neurol. 2008;255:1561–6. doi: 10.1007/s00415-008-0989-1. PubMed DOI
Leitinger M, Kalss G, Rohracher A, Pilz G, Novak H, Höfler J, Deak I, Kuchukhidze G, Dobesberger J, Wakonig A, Trinka E. Predicting outcome of status epilepticus. Epilepsy Behav. 2015;49:126–30. doi: 10.1016/j.yebeh.2015.04.066. PubMed DOI
Yuan F, Damien C, Gaspard N. Severity scores for status epilepticus in the ICU: systemic illness also matters. Crit Care. 2023;27:19. doi: 10.1186/s13054-022-04276-7. PubMed DOI PMC
Jayalakshmi S, Vooturi S. Outcome scores in status epilepticus – predicting the complex clinical situation. Eur J Neurol. 2016;23(11):1591–2. doi: 10.1111/ene.13124. PubMed DOI
Kannan L, Rathore C. Predicting the unpredictable: utility of Outcome Prediction scores in Status Epilepticus. Ann Indian Acad Neurol. 2021 May-Jun;24(3):313–4. PubMed PMC
Huang TH, Lai MC, Chen YS, Huang CW. Status Epilepticus Mortality Risk factors and a correlation survey with the newly modified STESS. Healthc (Basel) 2021;9(11):1570. PubMed PMC
Reindl C, Knappe RU, Sprügel MI, Sembill JA, Mueller TM, Hamer HM, Huttner HB, Madžar D. Comparison of scoring tools for the prediction of in-hospital mortality in status epilepticus. Seizure. 2018;56:92–7. doi: 10.1016/j.seizure.2018.01.024. PubMed DOI
Huang TH, Chen TS, Huang CW. External validation of newly modified status epilepticus severity score for predicting mortality in patients with status epilepticus in a regional hospital in Taiwan. Epilepsy Behav. 2023;149:109495. doi: 10.1016/j.yebeh.2023.109495. PubMed DOI
Yuan F, Damien C, Gaspard N. Prognostic scores in status epilepticus: A systematic review and meta-analysis. Epilepsia. 2023;64(1):17–28. 10.1111/epi.17442. Epub 2022 Nov 11. PMID: 36271624. PubMed
Hanin A, Lambrecq V, Denis JA, et al. Cerebrospinal fluid and blood biomarkers of status epilepticus. Epilepsia. 2020;61:6–18. doi: 10.1111/epi.16405. PubMed DOI
Nardone R, Brigo F, Trinka E. Acute symptomatic seizures caused by Electrolyte disturbances. J Clin Neurol. 2016;12:21–33. doi: 10.3988/jcn.2016.12.1.21. PubMed DOI PMC
Hanin A, Demeret S, Denis JA, Nguyen-Michel VH, Rohaut B, Marois C, Imbert-Bismut F, Bonnefont-Rousselot D, Levy P, Navarro V, Lambrecq V. Serum neuron-specific enolase: a new tool for seizure risk monitoring after status epilepticus. Eur J Neurol. 2022;29:883–9. doi: 10.1111/ene.15154. PubMed DOI
Muscedere J, Waters B, Varambally A, Bagshaw SM, Boyd JG, Maslove D, Sibley S, Rockwood K. The impact of frailty on intensive care unit outcomes: a systematic review and meta-analysis. Intensive Care Med. 2017;43:1105–22. doi: 10.1007/s00134-017-4867-0. PubMed DOI PMC
Jung C, Flaatten H, Fjølner J, Bruno RR, Wernly B, Artigas A, Bollen Pinto B, Schefold JC, Wolff G, Kelm M, Beil M, Sviri S, van Heerden PV, Szczeklik W, Czuczwar M, Elhadi M, Joannidis M, Oeyen S, Zafeiridis T, Marsh B, Andersen FH, Moreno R, Cecconi M, Leaver S, Boumendil A, De Lange DW, Guidet B, COVIP study group The impact of frailty on survival in elderly intensive care patients with COVID-19: the COVIP study. Crit Care. 2021;25:149. doi: 10.1186/s13054-021-03551-3. PubMed DOI PMC
Proietti M, Romiti GF, Raparelli V, Diemberger I, Boriani G, Dalla Vecchia LA, Bellelli G, Marzetti E, Lip GY, Cesari M. Frailty prevalence and impact on outcomes in patients with atrial fibrillation: a systematic review and meta-analysis of 1,187,000 patients. Ageing Res Rev. 2022;79:101652. doi: 10.1016/j.arr.2022.101652. PubMed DOI
Panayi AC, Orkaby AR, Sakthivel D, Endo Y, Varon D, Roh D, Orgill DP, Neppl RL, Javedan H, Bhasin S, Sinha I. Impact of frailty on outcomes in surgical patients: a systematic review and meta-analysis. Am J Surg. 2019;218:393–400. doi: 10.1016/j.amjsurg.2018.11.020. PubMed DOI PMC
Trinka E, Cock H, Hesdorffer D, Rossetti AO, Scheffer IE, Shinnar S, Shorvon S, Lowenstein DH. A definition and classification of status epilepticus – report of the ILAE Task Force on classification of Status Epilepticus. Epilepsia. 2015;56:1515–23. doi: 10.1111/epi.13121. PubMed DOI
Velanovich V, Antoine H, Swartz A, Peters D, Rubinfeld I. Accumulating deficits model of frailty and postoperative mortality and morbidity: its application to a national database. J Surg Res. 2013;183:104–10. doi: 10.1016/j.jss.2013.01.021. PubMed DOI
Team RC. R: A Language and Environment for Statistical Computing. Published online 2021. https://www.r-project.org/.
Fluss R, Faraggi D, Reiser B. Estimation of the Youden Index and its associated cutoff point. Biom J. 2005;47:458–72. doi: 10.1002/bimj.200410135. PubMed DOI
Semmlack S, Kaplan PW, Spiegel R, De Marchis GM, Hunziker S, Tisljar K, Rüegg S, Marsch S, Sutter R. Illness severity scoring in status epilepticus-when STESS meets APACHE II, SAPS II, and SOFA. Epilepsia. 2019;60:189–200. doi: 10.1111/epi.14623. PubMed DOI
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA, Cardiovascular Health Study Collaborative Research Group Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56:M146–56. doi: 10.1093/gerona/56.3.M146. PubMed DOI
Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, Mitnitski A. A global clinical measure of fitness and frailty in elderly people. CMAJ. 2005;173:489–95. doi: 10.1503/cmaj.050051. PubMed DOI PMC
Madžar D, Reindl C, Mrochen A, Hamer HM, Huttner HB. Value of initial C-reactive protein levels in status epilepticus outcome prediction. Epilepsia. 2021;62(4):e48–e52. doi: 10.1111/epi.16842. PubMed DOI
Sutter R, Grize L, Fuhr P, Rüegg S, Marsch S. Acute-phase proteins and mortality in status epilepticus: a 5-year observational cohort study. Crit Care Med. 2013;41(6):1526–33. doi: 10.1097/CCM.0b013e318287f2ac. PubMed DOI
Walker MC. Pathophysiology of status epilepticus. Neurosci Lett. 2018;667:84–91. doi: 10.1016/j.neulet.2016.12.044. PubMed DOI
Hanin A, Denis JA, Frazzini V, Cousyn L, Imbert-Bismut F, Rucheton B, Bonnefont-Rousselot D, Marois C, Lambrecq V, Demeret S, Navarro V. Neuron Specific Enolase, S100-beta protein and progranulin as diagnostic biomarkers of status epilepticus. J Neurol. 2022;269:3752–60. doi: 10.1007/s00415-022-11004-2. PubMed DOI
Chatzikonstantinou A, Ebert AD, Hennerici MG. Temporal seizure focus and status epilepticus are associated with high-sensitive troponin I elevation after epileptic seizures. Epilepsy Res. 2015;115:77–80. doi: 10.1016/j.eplepsyres.2015.05.013. PubMed DOI
Giovannini G, Meletti S. Fluid biomarkers of Neuro-Glial Injury in Human Status Epilepticus: a systematic review. Int J Mol Sci. 2023;24(15):12519. doi: 10.3390/ijms241512519. PubMed DOI PMC
Hosseini S, Mofrad AME, Mokarian P, Nourigheimasi S, Azarhomayoun A, Khanzadeh S, Habibzadeh S, Ghaedi A. Neutrophil to lymphocyte ratio in Epilepsy: a systematic review. Mediators Inflamm. 2022;2022:4973996. doi: 10.1155/2022/4973996. PubMed DOI PMC
Olivo S, Buoite Stella A, Pavan S, Cegalin M, Furlanis G, Cheli M, Tomaselli M, Stokelj D, Manganotti P. Admission neutrophil-to-lymphocyte ratio predicts length of hospitalization and need for ICU admission in adults with Status Epilepticus. Seizure. 2023;106:80–4. doi: 10.1016/j.seizure.2023.02.001. PubMed DOI