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Abstract Details

Are Recurrent Focal Seizures or Focal Status Epilepticus in Older Adults a Risk Factor for Early Mortality?
Epilepsy/Clinical Neurophysiology (EEG)
P4 - Poster Session 4 (11:45 AM-12:45 PM)
1-013

The increased life expectancy has led to an enormous demand for hospital admissions for older people. Clinical and electrographic seizures are common in older patients. Generalized convulsive status epilepticus (CSE) has long been associated with increased mortality. However, the most common type of SE in older patients is nonconvulsive SE (NCSE), and the outcomes of NCSE are not completely clear.  

The main goal of the present study is to determine whether focal nonmotor or motor seizures or status epilepticus (SE) are associated with 30-day mortality in older patients.  The second goal is to compare poor outcome predictors, such as comorbid conditions, in older patients with and without focal seizures and SE.

This retrospective study included patients aged 65 years or above admitted to Hackensack Meridian Health and JFK Neuroscience Institute from 2019 to 2022 with a diagnosis of recurrent focal nonconvulsive seizures or status epilepticus, recurrent focal motor seizures or SE based on continuous video-electroencephalogram. For comparison, we included a control group of patients aged 65 years or above without seizures. The age-adjusted Charlson Comorbidity Index (CCI) was compared between groups. 

There were 103 patients, 47 patients with focal seizures or SE aged 65 to 98, and 56 controls without seizures aged 65 to 90. When investigating the associations between 30-day mortality and several other variables, seizures (OR=4.50, 95% CI 1.41-17.5; p=0.010), high CCI scores (OR=7.83, 95% CI 1.16-122; p=0.033), and “Do not intubate” (DNI)/“Do not resuscitate” (DNR) code status (OR=5.35, 95% CI 1.75-19.1; p=0.003) increased the odds of short-term mortality.
Patients 65 and older with recurrent focal seizures or focal SE were 4-fold more likely to be deceased within 30 days. Other variables associated with early mortality included elevated CCI scores and DNI/DNR code status.
Authors/Disclosures
Abram Wahba, MD (JFK Medical Center)
PRESENTER
Dr. Wahba has nothing to disclose.
Diosely C. Silveira, MD, PhD (University of Texas Medical Branch) Dr. Silveira has nothing to disclose.
Michelle Lucena No disclosure on file
Michelle Ganat, MD (Montefiore Medical Center) Dr. Ganat has nothing to disclose.
Raquel Romero, MD (LPG Neurology) Dr. Romero has nothing to disclose.