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Войти в исследования Time to Treatment in Pediatric Convulsive Refractory Status Epilepticus: The Weekend Effect.
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Barcia Aguilar Cristina, Amengual-Gual Marta, Sánchez Fernández Iván, Abend Nicholas S, Anderson Anne, Appavu Brian, Arya Ravindra, Brenton J Nicholas, Carpenter Jessica L, Chapman Kevin E, Clark Justice, Farias-Moeller Raquel, Gaillard William D, Gaínza-Lein Marina, Glauser Tracy, Goldstein Joshua L, Goodkin Howard P, Guerriero Rejean M, Huh Linda, Lai Yi-Chen, McDonough Tiffani L, Mikati Mohamad A, Morgan Lyndsey A, Novotny Edward J, Ostendorf Adam, Payne Eric T, Peariso Katrina, Piantino Juan, Riviello James, Sannagowdara Kumar, Sheehan Theodore, Sands Tristan T, Tasker Robert C, Tchapyjnikov Dmitry, Topjian Alexis A, Vasquez Alejandra, Wainwright Mark S, Wilfong Angus A, Williams Korwyn, Loddenkemper Tobias, pSERG
Аннотация
METHODS: We performed a retrospective analysis of prospectively collected observational data of pediatric patients with refractory status epilepticus.
RESULTS: We included 329 patients (56% males) with a median (p25 to p75) age of 3.8 (1.3 to 9) years. The median (p25 to p75) time to first BZD on weekdays and weekends/holidays was 20 (6.8 to 48.3) minutes versus 11 (5 to 35) minutes, P = 0.01; adjusted hazard ratio (HR) = 1.20 (95% confidence interval [CI]: 0.95 to 1.55), P = 0.12. The time to first non-BZD ASM was longer on weekdays than on weekends/holidays (68 [42.8 to 153.5] minutes versus 59 [27 to 120] minutes, P = 0.006; adjusted HR = 1.38 [95% CI: 1.08 to 1.76], P = 0.009). However, this difference was mainly driven by status epilepticus with in-hospital onset: among 108 patients, the time to first non-BZD ASM was longer during weekdays than during weekends/holidays (55.5 [28.8 to 103.5] minutes versus 28 [15.8 to 66.3] minutes, P = 0.003; adjusted HR = 1.65 [95% CI: 1.08 to 2.51], P = 0.01).
CONCLUSIONS: The time to first non-BZD ASM in pediatric refractory status epilepticus is shorter on weekends/holidays than on weekdays, mainly driven by in-hospital onset status epilepticus. Data on what might be causing this difference may help tailor policies to improve medication application timing.