Observational studyEpilepsia2019
Duration of therapeutic coma and outcome of refractory status epilepticus.
Observational study in Epilepsia, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 56 citations in OpenAlex.
- Surgical Interventions for Super-Refractory Status Epilepticus: A Systematic Review.Neurocritical care · 2026Pooled it
- Association between incident delirium and 28- and 90-day mortality in critically ill adults: a secondary analysis.Critical care (London, England) · 2020Trial
- Defining the end point of status epilepticus: A scoping review and framework for standardization.Epilepsia · 2026Article
- Treatment of convulsive status epilepticus in Brazil: a review.Arquivos de neuro-psiquiatria · 2025Review
- ICU patient-on-a-chip emulating orchestration of mast cells and cerebral organoids in neuroinflammation.Communications biology · 2024Article
- The Origin of the Burst-Suppression Paradigm in Treatment of Status Epilepticus.Neurocritical care · 2024Article
- Status epilepticus in the ICU.Intensive care medicine · 2024Review
- Effects of epileptiform activity on discharge outcome in critically ill patients in the USA: a retrospective cross-sectional study.The Lancet. Digital health · 2023Article
- Status Epilepticus in Older Adults: Diagnostic and Treatment Considerations.Drugs & aging · 2023Article
- Propofol mitigates brain injury and oxidative stress, and enhances GABAA receptor α1 subunit expression in a rat model of lithium chloride-pilocarpine induced status epilepticus.Turkish journal of medical sciences · 2023Article
- Duration of constant rate infusion with diazepam or propofol for canine cluster seizures and status epilepticus.Frontiers in veterinary science · 2023Article
- A practical approach to in-hospital management of new-onset refractory status epilepticus/febrile infection related epilepsy syndrome.Frontiers in neurology · 2023Review
- Management of Refractory Status Epilepticus: An International Cohort Study (MORSE CODe) Analysis of Patients Managed in the ICU.Neurology · 2022Article
- Constant rate infusion of diazepam or propofol for the management of canine cluster seizures or status epilepticus.Frontiers in veterinary science · 2022Article
- [S2k guidelines: status epilepticus in adulthood : Guidelines of the German Society for Neurology].Der Nervenarzt · 2021Review
- Review and Updates on the Treatment of Refractory and Super Refractory Status Epilepticus.Journal of clinical medicine · 2021Review
- Review
- Seizure Management in the Intensive Care Unit.Current treatment options in neurology · 2021Review
- Electroencephalogram Monitoring in Critical Care.Seminars in neurology · 2020Review
- A Theoretical Paradigm for Evaluating Risk-Benefit of Status Epilepticus Treatment.Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveExamine the association of duration of therapeutic coma (TC) with seizure recurrence, morbidity, and mortality in refractory status epilepticus (RSE). Define an optimal window for TC that provides sustained seizure control and minimizes complications.
methodsRetrospective, observational cohort study involving patients who presented with RSE to the University of Alabama at Birmingham or the University of California at San Francisco from 2010 to 2016. Relationship of duration of TC with primary and secondary outcomes was evaluated using two-sample t tests, simple linear regression, and chi-square tests. Multivariable linear and logistic regression models were used to identify independent predictors. Predictive ability of TC for seizure recurrence was quantified using a receiver-operating characteristic curve. Youden index was used to determine an optimal cutoff value.
resultsMultivariable analysis of clinical and treatment characteristics of 182 patients who were treated predominantly with propofol as anesthetic agent showed that longer duration of the first trial of TC (27.2 vs 15.6 hours) was independently associated with a higher chance of seizure recurrence following the first weaning attempt (P = 0.038) but not with poor functional neurologic outcome upon discharge, in-hospital complications, or mortality. Furthermore, higher doses of anesthetic utilized during the first trial of TC were independently associated with fewer in-hospital complications (P = 0.003) and associated with a shorter duration of mechanical ventilation and total length of stay. Duration of TC was identified as an independent predictor of seizure recurrence with an optimal cutoff point at 35 hours. SIGNIFICANCE: This study suggests that a shorter duration yet deeper TC as treatment for RSE may be more effective and safer than the currently recommended TC duration of 24-48 hours. Prospective and randomized trials should be conducted to validate these assertions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.