TY -的T1 -协会Peri-ictal MRI异常与死亡率,抗癫痫药物耐火性和发病率在癫痫持续状态JF -神经学乔-神经病学SP - e943 LP - e953做- 10.1212 / WNL。首页0000000000201599六世- 100 - 9盟-托马斯Bonduelle盟Kilian指标-摩根Ollivier盟盟-本杰明·托马斯AU -安东尼Daubigney AU -薇罗尼卡米歇尔AU -玛丽·德·Montaudouin盟塞西尔Marchal盟——杰罗姆Aupy Y1 - 2023/02/28 UR - //www.ez-admanager.com/content/100/9/e943.abstract N2 -背景和目标癫痫持续状态(SE)是一种危及生命的紧急需要一个提示患者预后首页的评估指导管理。磁共振成像允许识别peri-ictal MRI异常(pma),并提供洞察SE引起的大脑结构的修改。然而,对PMA在SE预后的重要性。本研究的目的是确定是否与死亡率增加有关PMA SE和建立抗癫痫药物PMA和耐火度之间的联系,遇到的并发症,引起的发病率。方法:我们进行了一项回顾性观察性队列研究包括所有符合条件的连续患者超过15岁,住院SE波尔多大学医院(法国)2015年1月至2019年12月。主要终点是住院死亡率。专用neuroradiologic进行重新评估,连同一个全面的医疗检查评估基线特征,住院死亡,SE表征,药物耐火性,结果后的幸存者。结果包括307例患者,79例(26%)显示PMA有关。人口结构、功能状态在基线和SE发病之间的平均延迟和MRI检查在PMA-positive和PMA-negative组相似。住院死亡发生于15%(45/307)患者和明显高于PMA-positive组(27%,21/79 vs 11%, 24/228;p & lt; 0.001). In multivariate analysis, the presence of PMA (odds ratio [OR] 2.86, 95% CI 1.02–8.18; p = 0.045), together with SE duration (OR 1.01, 95% CI 1.01–1.02; p = 0.007), older age at SE onset (OR 1.05, 95% CI 1.01–1.09; p = 0.013), preexisting ultimately fatal comorbidity (OR 4.01, 95% CI 1.56–10.6; p = 0.004), and acute lesional SE etiology (OR 3.74, 95% CI 1.45–10.2; p = 0.007) were independent predictors associated with in-hospital death. Patients with PMA had a higher risk of refractory SE (71 vs 33%, p < 0.001). Among survivors, delayed-onset epilepsy (40% vs 21%, p = 0.009) occurred more frequently in the PMA-positive group.Discussion PMA-positive cases had a higher mortality rate in the largest cohort so far to assess the prognosis value of PMA in SE. As a noninvasive and easily available tool, PMA represents a promising structural biomarker for developing a personalized approach to prognostication in patients with SE receiving MRI.ADC=apparent diffusion coefficient; CVD=cerebrovascular disease; DWI=diffusion-weighted MRI; EMSE=epidemiology-based mortality score in status epilepticus; ETI=endotracheal intubation; FLAIR=fluid-attenuated inversion recovery; ICU=intensive care unit; ILAE=International League Against Epilepsy; IQR=interquartile range; LPD=lateralized periodic discharge; mRS=modified Rankin Scale; OR=odds ratio; PMA=peri-ictal MRI abnormality; SE=status epilepticus; STESS=status epilepticus severity score ER -