Impact of frailty, biomarkers and basic biochemical parameters on outcomes of comatose patients in status epilepticus: a single-center prospective pilot study

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-...

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Published in:	BMC neurology Vol. 24; no. 1; pp. 46 - 8
Main Authors:	Krejzar, Zdenek, Sila, David, Waldauf, Petr, Kuriscak, Eduard, Mokrejs, Petr, Spatenkova, Vera
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 26-01-2024 BioMed Central BMC
Subjects:	Adult Age Aged Biological markers Biomarkers Blood C-reactive protein Calcium (blood) CFS Coma Coma - diagnosis Convulsions & seizures Critically ill Data analysis Encephalopathy Epilepsy Female Frailty Hospital patients Hospitals Humans Hypoxia Infant Intensive care Male Mechanical ventilation Middle Aged Neurological research Neurology Outcome Patient outcomes Patients Pilot Projects Potassium Prognosis Prospective Studies Proteins Regression analysis Retrospective Studies Risk factors Score Severity of Illness Index Status epilepticus Status Epilepticus - diagnosis STESS Troponin Troponin T Variables Ventilators United Kingdom Basel Switzerland Switzerland CFS mFI-11 Score Outcome Frailty STESS Status epilepticus
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Summary:	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. 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. 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. 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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1471-2377 1471-2377
DOI:	10.1186/s12883-024-03537-y