TY - JOUR
T1 - Association of guideline publication and delays to treatment in pediatric status epilepticus
AU - Sánchez Fernández, Iván
AU - Abend, Nicholas S.
AU - Amengual-Gual, Marta
AU - Anderson, Anne
AU - Arya, Ravindra
AU - Aguilar, Cristina Barcia
AU - Brenton, James Nicholas
AU - Carpenter, Jessica L.
AU - Chapman, Kevin E.
AU - Clark, Justice
AU - Farias-Moeller, Raquel
AU - Gaillard, William D.
AU - Gaínza-Lein, Marina
AU - Glauser, Tracy
AU - Goldstein, Joshua
AU - Goodkin, Howard P.
AU - Guerriero, Réjean M.
AU - Lai, Yi Chen
AU - McDonough, Tiffani
AU - Mikati, Mohamad A.
AU - Morgan, Lindsey A.
AU - Novotny, Edward
AU - Payne, Eric
AU - Peariso, Katrina
AU - Piantino, Juan
AU - Ostendorf, Adam
AU - Sands, Tristan T.
AU - Sannagowdara, Kumar
AU - Tasker, Robert C.
AU - Tchapyjnikov, Dimtry
AU - Topjian, Alexis A.
AU - Vasquez, Alejandra
AU - Wainwright, Mark S.
AU - Wilfong, Angus
AU - Williams, Kowryn
AU - Loddenkemper, Tobias
N1 - Publisher Copyright:
© American Academy of Neurology.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - ObjectiveTo determine whether publication of evidence on delays in time to treatment shortens time to treatment in pediatric refractory convulsive status epilepticus (rSE), we compared time to treatment before (2011-2014) and after (2015-2019) publication of evidence of delays in treatment of rSE in the Pediatric Status Epilepticus Research Group (pSERG) as assessed by patient interviews and record review.MethodsWe performed a retrospective analysis of a prospectively collected dataset from June 2011 to September 2019 on pediatric patients (1 month-21 years of age) with rSE.ResultsWe studied 328 patients (56% male) with median (25th-75th percentile [p25-p75]) age of 3.8 (1.3-9.4) years. There were no differences in the median (p25-p75) time to first benzodiazepine (BZD) (20 [5-52.5] vs 15 [5-38] minutes, p = 0.3919), time to first non-BZD antiseizure medication (68 [34.5-163.5] vs 65 [33-142] minutes, p = 0.7328), and time to first continuous infusion (186 [124.2-571] vs 160 [89.5-495] minutes, p = 0.2236). Among 157 patients with out-of-hospital onset whose time to hospital arrival was available, the proportion who received at least 1 BZD before hospital arrival increased after publication of evidence of delays (41 of 81 [50.6%] vs 57 of 76 [75%], p = 0.0018), and the odds ratio (OR) was also increased in multivariable logistic regression (OR 4.35 [95% confidence interval 1.96-10.3], p = 0.0005).ConclusionPublication of evidence on delays in time to treatment was not associated with improvements in time to treatment of rSE, although it was associated with an increase in the proportion of patients who received at least 1 BZD before hospital arrival.
AB - ObjectiveTo determine whether publication of evidence on delays in time to treatment shortens time to treatment in pediatric refractory convulsive status epilepticus (rSE), we compared time to treatment before (2011-2014) and after (2015-2019) publication of evidence of delays in treatment of rSE in the Pediatric Status Epilepticus Research Group (pSERG) as assessed by patient interviews and record review.MethodsWe performed a retrospective analysis of a prospectively collected dataset from June 2011 to September 2019 on pediatric patients (1 month-21 years of age) with rSE.ResultsWe studied 328 patients (56% male) with median (25th-75th percentile [p25-p75]) age of 3.8 (1.3-9.4) years. There were no differences in the median (p25-p75) time to first benzodiazepine (BZD) (20 [5-52.5] vs 15 [5-38] minutes, p = 0.3919), time to first non-BZD antiseizure medication (68 [34.5-163.5] vs 65 [33-142] minutes, p = 0.7328), and time to first continuous infusion (186 [124.2-571] vs 160 [89.5-495] minutes, p = 0.2236). Among 157 patients with out-of-hospital onset whose time to hospital arrival was available, the proportion who received at least 1 BZD before hospital arrival increased after publication of evidence of delays (41 of 81 [50.6%] vs 57 of 76 [75%], p = 0.0018), and the odds ratio (OR) was also increased in multivariable logistic regression (OR 4.35 [95% confidence interval 1.96-10.3], p = 0.0005).ConclusionPublication of evidence on delays in time to treatment was not associated with improvements in time to treatment of rSE, although it was associated with an increase in the proportion of patients who received at least 1 BZD before hospital arrival.
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U2 - 10.1212/WNL.0000000000010174
DO - 10.1212/WNL.0000000000010174
M3 - Article
C2 - 32611646
AN - SCOPUS:85090171140
SN - 0028-3878
VL - 95
SP - E1222-E1235
JO - Neurology
JF - Neurology
IS - 9
ER -