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Association of guideline publication and delays to treatment in pediatric status epilepticus.

Publication ,  Journal Article
Sánchez Fernández, I; Abend, NS; Amengual-Gual, M; Anderson, A; Arya, R; Barcia Aguilar, C; Brenton, JN; Carpenter, JL; Chapman, KE; Clark, J ...
Published in: Neurology
September 1, 2020

OBJECTIVE: To determine whether publication of evidence on delays in time to treatment shortens time to treatment in pediatric refractory convulsive status epilepticus (rSE), we compared time to treatment before (2011-2014) and after (2015-2019) publication of evidence of delays in treatment of rSE in the Pediatric Status Epilepticus Research Group (pSERG) as assessed by patient interviews and record review. METHODS: We performed a retrospective analysis of a prospectively collected dataset from June 2011 to September 2019 on pediatric patients (1 month-21 years of age) with rSE. RESULTS: We studied 328 patients (56% male) with median (25th-75th percentile [p25-p75]) age of 3.8 (1.3-9.4) years. There were no differences in the median (p25-p75) time to first benzodiazepine (BZD) (20 [5-52.5] vs 15 [5-38] minutes, p = 0.3919), time to first non-BZD antiseizure medication (68 [34.5-163.5] vs 65 [33-142] minutes, p = 0.7328), and time to first continuous infusion (186 [124.2-571] vs 160 [89.5-495] minutes, p = 0.2236). Among 157 patients with out-of-hospital onset whose time to hospital arrival was available, the proportion who received at least 1 BZD before hospital arrival increased after publication of evidence of delays (41 of 81 [50.6%] vs 57 of 76 [75%], p = 0.0018), and the odds ratio (OR) was also increased in multivariable logistic regression (OR 4.35 [95% confidence interval 1.96-10.3], p = 0.0005). CONCLUSION: Publication of evidence on delays in time to treatment was not associated with improvements in time to treatment of rSE, although it was associated with an increase in the proportion of patients who received at least 1 BZD before hospital arrival.

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Published In

Neurology

DOI

EISSN

1526-632X

Publication Date

September 1, 2020

Volume

95

Issue

9

Start / End Page

e1222 / e1235

Location

United States

Related Subject Headings

  • Young Adult
  • Time-to-Treatment
  • Status Epilepticus
  • Retrospective Studies
  • Professional Practice Gaps
  • Practice Guidelines as Topic
  • Neurology & Neurosurgery
  • Male
  • Length of Stay
  • Intensive Care Units, Pediatric
 

Citation

APA
Chicago
ICMJE
MLA
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Sánchez Fernández, I., Abend, N. S., Amengual-Gual, M., Anderson, A., Arya, R., Barcia Aguilar, C., … pSERG, . (2020). Association of guideline publication and delays to treatment in pediatric status epilepticus. Neurology, 95(9), e1222–e1235. https://doi.org/10.1212/WNL.0000000000010174
Sánchez Fernández, Iván, Nicholas S. Abend, Marta Amengual-Gual, Anne Anderson, Ravindra Arya, Cristina Barcia Aguilar, James Nicholas Brenton, et al. “Association of guideline publication and delays to treatment in pediatric status epilepticus.Neurology 95, no. 9 (September 1, 2020): e1222–35. https://doi.org/10.1212/WNL.0000000000010174.
Sánchez Fernández I, Abend NS, Amengual-Gual M, Anderson A, Arya R, Barcia Aguilar C, et al. Association of guideline publication and delays to treatment in pediatric status epilepticus. Neurology. 2020 Sep 1;95(9):e1222–35.
Sánchez Fernández, Iván, et al. “Association of guideline publication and delays to treatment in pediatric status epilepticus.Neurology, vol. 95, no. 9, Sept. 2020, pp. e1222–35. Pubmed, doi:10.1212/WNL.0000000000010174.
Sánchez Fernández I, Abend NS, Amengual-Gual M, Anderson A, Arya R, Barcia Aguilar C, Brenton JN, Carpenter JL, Chapman KE, Clark J, Farias-Moeller R, Gaillard WD, Gaínza-Lein M, Glauser T, Goldstein J, Goodkin HP, Guerriero RM, Lai Y-C, McDonough T, Mikati MA, Morgan LA, Novotny E, Payne E, Peariso K, Piantino J, Ostendorf A, Sands TT, Sannagowdara K, Tasker RC, Tchapyjnikov D, Topjian AA, Vasquez A, Wainwright MS, Wilfong A, Williams K, Loddenkemper T, pSERG. Association of guideline publication and delays to treatment in pediatric status epilepticus. Neurology. 2020 Sep 1;95(9):e1222–e1235.

Published In

Neurology

DOI

EISSN

1526-632X

Publication Date

September 1, 2020

Volume

95

Issue

9

Start / End Page

e1222 / e1235

Location

United States

Related Subject Headings

  • Young Adult
  • Time-to-Treatment
  • Status Epilepticus
  • Retrospective Studies
  • Professional Practice Gaps
  • Practice Guidelines as Topic
  • Neurology & Neurosurgery
  • Male
  • Length of Stay
  • Intensive Care Units, Pediatric