en
Scientific article
Open access
English

Sex-related differences in adult patients with status epilepticus : a seven-year two-center observation

Published inCritical care, vol. 27, no. 1, 308
Publication date2023-08-05
First online date2023-08-05
Abstract

Background

Conflicting findings exist regarding the influence of sex on the development, treatment, course, and outcome of status epilepticus (SE). Our study aimed to investigate sex-related disparities in adult SE patients, focusing on treatment, disease course, and outcome at two Swiss academic medical centers.

Methods

In this retrospective study, patients treated for SE at two Swiss academic care centers from Basel and Geneva from 2015 to 2021 were included. Primary outcomes were return to premorbid neurologic function, death during hospital stay and at 30 days. Secondary outcomes included characteristics of treatment and disease course. Associations with primary and secondary outcomes were assessed using multivariable logistic regression. Analysis using propensity score matching was performed to account for the imbalances regarding age between men and women.

Results

Among 762 SE patients, 45.9% were women. No sex-related differences were found between men and women, except for older age and lower frequency of intracranial hemorrhages in women. Compared to men, women had a higher median age (70 vs. 66, p = 0.003), had focal nonconvulsive SE without coma more (34.9% vs. 25.5%; p = 0.005) and SE with motor symptoms less often (52.3% vs. 63.6%, p = 0.002). With longer SE duration (1 day vs. 0.5 days, p = 0.011) and a similar proportion of refractory SE compared to men (36.9% vs. 36.4%, p = 0.898), women were anesthetized and mechanically ventilated less often (30.6% vs. 42%, p = 0.001). Age was associated with all primary outcomes in the unmatched multivariable analyses, but not female sex. In contrast, propensity score-matched multivariable analyses revealed decreased odds for return to premorbid neurologic function for women independent of potential confounders. At hospital discharge, women were sent home less (29.7% vs. 43.7%, p < 0.001) and to nursing homes more often (17.1% vs. 10.0%, p = 0.004).

Conclusions

This study identified sex-related disparities in the clinical features, treatment modalities, and outcome of adult patients with SE with women being at a disadvantage, implying that sex-based factors must be considered when formulating strategies for managing SE and forecasting outcomes.

eng
Keywords
  • Neurocritical care
  • Sex
  • Status epilepticus
Citation (ISO format)
BAUMANN, Sira M. et al. Sex-related differences in adult patients with status epilepticus : a seven-year two-center observation. In: Critical care, 2023, vol. 27, n° 1, p. 308. doi: 10.1186/s13054-023-04592-6
Main files (1)
Article (Published version)
Identifiers
ISSN of the journal1364-8535
18views
3downloads

Technical informations

Creation12/04/2023 2:45:25 PM
First validation03/06/2024 10:58:49 AM
Update time03/06/2024 10:58:49 AM
Status update03/06/2024 10:58:49 AM
Last indexation05/06/2024 6:06:37 PM
All rights reserved by Archive ouverte UNIGE and the University of GenevaunigeBlack