@article{44d77af9edb945e38bdc9047279ce6f1,
title = "Factors associated with treatment delays in pediatric refractory convulsive status epilepticus",
abstract = "Objective To identify factors associated with treatment delays in pediatric patients with convulsive refractory status epilepticus (rSE). Methods This prospective, observational study was performed from June 2011 to March 2017 on pediatric patients (1 month to 21 years of age) with rSE. We evaluated potential factors associated with increased treatment delays in a Cox proportional hazards model. Results We studied 219 patients (53% males) with a median (25th-75th percentiles [p25-p75]) age of 3.9 (1.2-9.5) years in whom rSE started out of hospital (141 [64.4%]) or in hospital (78 [35.6%]). The median (p25-p75) time from seizure onset to treatment was 16 (5-45) minutes to first benzodiazepine (BZD), 63 (33-146) minutes to first non-BZD antiepileptic drug (AED), and 170 (107-539) minutes to first continuous infusion. Factors associated with more delays to administration of the first BZD were intermittent rSE (hazard ratio [HR] 1.54, 95% confidence interval [CI] 1.14-2.09; p = 0.0467) and out-of-hospital rSE onset (HR 1.5, 95% CI 1.11-2.04; p = 0.0467). Factors associated with more delays to administration of the first non-BZD AED were intermittent rSE (HR 1.78, 95% CI 1.32-2.4; p = 0.001) and out-of-hospital rSE onset (HR 2.25, 95% CI 1.67-3.02; p < 0.0001). None of the studied factors were associated with a delayed administration of continuous infusion. Conclusion Intermittent rSE and out-of-hospital rSE onset are independently associated with longer delays to administration of the first BZD and the first non-BZD AED in pediatric rSE. These factors identify potential targets for intervention to reduce time to treatment.",
author = "{Pediatric Status Epilepticus Research Group (pSERG)} and {S{\'a}nchez Fern{\'a}ndez}, I. and M. Ga{\'i}nza-Lein and Abend, {N. S.} and Anderson, {A. E.} and R. Arya and Brenton, {J. N.} and Carpenter, {J. L.} and Chapman, {K. E.} and J. Clark and Gaillard, {W. D.} and Glauser, {T. A.} and Goldstein, {Joshua L} and Goodkin, {H. P.} and Helseth, {A. R.} and Jackson, {M. C.} and K. Kapur and Lai, {Y. C.} and McDonough, {Tiffani Leigh} and Mikati, {M. A.} and A. Nayak and K. Peariso and Riviello, {J. J.} and Tasker, {R. C.} and D. Tchapyjnikov and Topjian, {A. A.} and Wainwright, {M. S.} and A. Wilfong and K. Williams and T. Loddenkemper",
note = "Funding Information: This study was funded by the Epilepsy Foundation of America, the American Epilepsy Society, and the Pediatric Epilepsy Research Foundation. Some authors report serving on journal editorial boards, advisory boards for pharmaceutical companies, and various professional society committees; receiving funding from foundations, pharmaceutical companies, and government agencies; receiving patent royalties, publication royalties, and speaker{\textquoteright}s honoraria; being party to pending patents; providing expert testimony, medical services, and consulting; and having spouses who provide medical and editorial services. Go to Neurology.org/N for full disclosures. Funding Information: This study and consortium were funded by the Epilepsy Foundation of America (EF-213583, Targeted Initiative for Health Outcomes), by the American Epilepsy Society/ Epilepsy Foundation of America Infrastructure Award, by the Pediatric Epilepsy Research Foundation, and the Epilepsy Research Fund. Publisher Copyright: {\textcopyright} 2018 American Academy of Neurology",
year = "2018",
month = may,
day = "8",
doi = "10.1212/WNL.0000000000005488",
language = "English (US)",
volume = "90",
pages = "E1692--E1701",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "19",
}