Influence of comorbidities on the prognosis of patients with status epilepticus and modification of Comorbidity Burden Index： A practicality study
10.19845/j.cnki.zfysjjbzz.2025.0135
- VernacularTitle:癫痫持续状态患者共患病对其预后的影响及改良共患病负担指数评分的实用性研究
- Author:
Yuanyuan LUO
1
;
Yu ZHANG
1
;
Ling LIU
2
Author Information
1. 四川大学华西医院神经内科，四川 成都 610041;成都上锦南府医院神经内科，四川 成都 611730
2. 四川大学华西医院神经内科，四川 成都 610041
- Publication Type:Journal Article
- Keywords:
Status epilepticus;
Comorbidities;
Prognosis;
Improved Comorbidity Burden Index
- MeSH:
Prognosis
- From:
Journal of Apoplexy and Nervous Diseases
2025;42(8):704-710
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the influence of comorbidities on the prognosis of patients with status epilepticus， to develop Improved Comorbidity Burden Index （ICBI） based on Comorbidity Burden Index （CBI）， and to analyze the practicality of ICBI in assessing nonconvulsive status epilepticus in western China.Methods A total of 396 patients with status epilepticus who were treated in Department of Neurology， Intensive Care Unit， and Emergency Department， West China Hospital， Sichuan University， from December 2016 to December 2022 were enrolled， and all patients met the latest diagnostic criteria for status epilepticus issued by the International League Against Epilepsy （2015 edition）. SPSS 22.0 was used to perform a statistical analysis， and a Logistic regression analysis was used to investigate the influencing factors for in-hospital death and poor prognosis （with a Glasgow Outcome Scale score of 1-3）. CBI score was modified into ICBI score， with the addition of three comorbidities （immune system disorder， thyroid dysfunction， and hypoproteinemia） and consolidation of overlapping items， and the total score was calculated with each comorbidity contributing 1 score. The MedCalc-generated receiver operating characteristic （ROC） curve was used to analyze predictive value， and the area under the ROC curve （AUC） was used to reflect the diagnostic value of ICBI scale.Results Among the 396 patients with status epilepticus included in the study， 43 （10.9%） died in hospital and 114 （28.8%） had a poor prognosis. Digestive system diseases， respiratory system diseases， kidney and urinary system diseases， electrolyte/acid-base imbalance， infection， and immune system disorders were risk factors for in-hospital death of patients with status epilepticus. Digestive system diseases， respiratory system diseases， kidney and urinary system diseases， electrolyte/acid-base imbalance， hypoglycemia/hyperglycemia， infection， coagulation and blood disorders， nervous system disease， cardiovascular diseases， musculoskeletal disorders， and immune system disorders were risk factors for poor prognosis in patients with status epilepticus. The ROC curve analysis showed that ICBI>3 had an AUC of 0.914 in predicting in-hospital death， with a specificity of 71.37% and a sensitivity of 97.67% （P<0.000 1）， and ICBI>3 had an AUC of 0.882 in predicting poor prognosis， with a specificity of 81.56% and a sensitivity of 79.82% （P<0.000 1）. There were 327 patients with convulsive status epilepticus， among whom 41 patients died， and ICBI>3 had an AUC of 0.915 in predicting in-hospital death （P<0.000 1）. There were 100 patients with a poor prognosis， and ICBI>3 had an AUC of 0.867 in predicting poor prognosis （P<0.000 1）.Conclusion The in-hospital mortality rate is 10.9% in patients with status epilepticus in Sichuan， China， and ICBI>3 has a certain value in predicting in-hospital death and poor prognosis in patients with status epilepticus. There is no significant difference in ICBI score between convulsive status epilepticus and nonconvulsive status epilepticus.
- Full text:2025090410254682318癫痫持续状态患者共患病对其预后的影响及改良共患病负担指数评分的实用性研究.pdf
