Introduction Status epilepticus (SE) is associated with significant morbidity and has a mortality rate of approximately 25%. This audit explores the management of SE in the University Hospital of Wales, Cardiff.
Method We audited 25 patients who presented with SE between 2009 and 2013. Cases were identified through clinical coding, a proforma was prepared from NICE guidelines and data obtained from individual case notes.
Results The median age and length of stay was 57 years and 6 days respectively. 40% of patients required Intensive Care (12 were intubated) and overall only 56% of patients received Neurology input. Approximately two-thirds were classified as convulsive SE and a third of cases were de-novo. The most common precipitant was infection (20%), and in 28% of cases no obvious cause was identified. 44% were treated with lorazepam in 1st-2nd stages of SE, and phenytoin was used in 80% in 3rd stage. 19 of the 25 patients were successfully discharged home or repatriated. Overall the mortality rate was 24% (6) and 12% (3) developed an aspiration pneumonia.
Conclusion Overall SE was relatively well managed with 76% of patients surviving. However, seeking a specialist opinion, drug and toxicology screens represent areas for improvement.