032 - Retrospective Chart Review of Adherence to Status Epilepticus Protocol: Enhancing Seizure Management and Patient Outcomes in Multiple Healthcare Settings

Publication Number: 32.6441

Jasmine Policherla, Children's Hospital of Michigan, Detroit, MI, United States; Dennis Leung, Children's Hospital of Michigan, Royal Oak, MI, United States

Background: Status Epilepticus is a very serious, potentially fatal condition that has been studied extensively for several years taking into account numerous variables in an effort to look into the prevention of the condition. Due to the severity of the condition the response has been protocoled across medical institutions, however few studies have been done to assess that adherence in a real-time clinical setting.

Objective: To evaluate adherence to the established status epilepticus protocol across multiple healthcare settings through a retrospective chart review. This study aims to provide insights that can inform targeted interventions to enhance protocol adherence, optimize seizure management, and improve overall patient outcomes in diverse clinical environments.

Design/Methods: A retrospective analysis of patients admitted to the Children’s Hospital of Michigan in status epilepticus from 2018-2022. Patient demographics, patient history, clinical course, and patient outcomes were recorded in a systemic fashion. Electronic medical records were reviewed for each admission in status epilepticus, time to administration of anti-seizure medications, and length of hospital stay.

Results: A total of 47 patients and 147 admissions in status epilepticus were reviewed. Patients who were stabilized at another hospital facility or received out-of-hospital anti-seizure medications were excluded. Patients with a documented history of severe neurological or metabolic disorders that could confound the assessment of status epilepticus treatment and outcome were also excluded.

Of the number of patients, 82% (41/47) were seen in the emergency department. Only 10% and 1% were treated on the general floor and pediatric intensive care unit respectively. The admissions were further divided into two groups; 57% adherent vs. 42% non-adherent to the hospital protocol. The time to treatment of the non-adherent group was about four times longer for both first and second line treatments when compared to the adherent group. It was also seen that patients in the non-adherent group on average also had a longer length of hospital stay (3.14 days) when compared to the adherent group (2.09 days).

Conclusion(s): We provide a single center retrospective data analysis of admissions in status epilepticus from a protocol perspective. It was found that the pediatric status epilepticus protocol was only adhered to about two-thirds of the time. For the cohort of patients where the protocol was not adhered to; these patients had longer time to treatment and longer hospitalizations as a result.