CLINICAL CHARACTERISTICS, OUTCOME, AND FACTORS ASSOCIATED WITH MORTALITY IN PATIENTS WITH STATUS EPILEPTICUS AT SELECTED PUBLIC HEALTH HOSPITALS IN ADDIS ABABA, ETHIOPIA

Abstract

ABSTRACT Background: Status epilepticus is a severe neurological emergency condition characterized by continuous, generalized convulsive seizure lasting for more than 5 minutes or two or more seizures without regaining consciousness. It is frequently associated with high death and morbidity rates. Objective: To assess the clinical profile and in hospital outcome and associated factors of patients with convulsive status epilepticus among patients at St. Paul's Hospital Millennium Medical College, Tikur Anbessa Specialized Hospital and Aabet Hospital in Addis Ababa Ethiopia January 1, 2019 to September 30, 2022. Methods: Retrospective cross-sectional descriptive study was carried out on the medical records of on 224 SE patients admitted to three public hospitals in Addis Ababa during the study period. For data analysis SPSS version 26 was used. Multivariate logistic regression analysis was performed to determine associated factors of poor outcome. The results were presented using tables, graphs and pie chart. All tests with P-Value <0.05 were considered statistically significant. Results: Mean age was 37.8 years with 53.3% females. Pre-existing epilepsy was 34.4%. Major SE etiologies were stroke (20%), antiepileptic drug withdrawal (17.8%), central nervous system infections (13.3%), and brain tumors (12.2%). Over 50% had complications, largely aspiration pneumonia. Case fatality rate was 17.4%. Mortality predictors were HIV/AIDS with CNS complications (AOR 3.50, 95% CI 0.97-18.75), CNS infections (AOR 4.61, 95% CI 0.99-21.33) and having ≥2 complications (AOR 10.50, 95% CI 1.44-76.28). Conclusion: Stroke, infections and drug non-compliance were major SE causes. Case fatality was high, associated with CNS infections and complications. The study highlights that non-communicable diseases like stroke are emerging as major contributors, while preventable causes like treatment non-compliance and infections continue to play a significant role in status epilepticus. Recommendations: Guideline implementation, EEG access, medication compliance promotion, infection control and complication prevention should be prioritized to improve SE outcomes. Further studies on semiology and larger datasets could strengthen evidence