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Shi X, Zhang X, Song S, Pan H, Huang C, Sun T, Wang S, Xu J. Correlation between inflammatory markers over time and disease severity in status epilepticus: a preliminary study. Front Neurol 2024; 15:1334415. [PMID: 38370523 PMCID: PMC10869547 DOI: 10.3389/fneur.2024.1334415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/12/2024] [Indexed: 02/20/2024] Open
Abstract
Objectives Convulsive status epilepticus (CSE) is a major subtype of status epilepticus that is known to be closely associated with systemic inflammation. Some important inflammatory biomarkers of this disorder include the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune inflammation index (SII), and pan-immune inflammation value (PIV). This study aimed to determine the NLR, PLR, MLR, SII, and PIV levels before and after treatment in adult patients with CSE and investigated the relationship of these parameters with disease severity. Methods This retrospective study analyzed data from 103 adult patients with CSE and 103 healthy controls. The neutrophil, monocyte, platelet, and lymphocyte counts, as well as the NLR, PLR, MLR, SII, and PIV, were compared in adult patients with CSE during acute seizures (within 2 h of admission) and after treatment relief (1-2 weeks of complete seizure control). Furthermore, multivariate linear regression analysis investigated the relationship between NLR, PLR, MLR, SII, and PIV with the Status Epilepticus Severity Score (STESS). Results The data revealed significant differences (p < 0.05) in neutrophils, monocytes, lymphocytes, NLR, PLR, MLR, SII, and PIV between adult patients with CSE during acute seizures and after treatment relief. The average neutrophil count was high during acute seizures in the patient group and decreased after remission. In contrast, the average lymphocyte count was lower after remission (p < 0.05). Furthermore, significant differences (p < 0.05) were observed in monocytes, lymphocytes, platelets, NLR, PLR, MLR, and PIV levels between adult patients with CSE after remission and the healthy control group. Multivariate linear regression analysis showed no significant correlation between NLR, PLR, MLR, SII, and PIV with STESS. Conclusion The results of this study indicated that adult patients with CSE experienced a transient systemic inflammatory response during acute seizures, which gradually returned to baseline levels after remission. However, there was a lack of robust clinical evidence correlating the severity of adult CSE and systemic inflammatory response.
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Affiliation(s)
- Xiangsong Shi
- Department of Neurology, Huai'an Third People's Hospital, Huai'an, China
| | - Xiulin Zhang
- Department of Neurology, Huai'an Third People's Hospital, Huai'an, China
| | - Sumeng Song
- Department of Neurology, Huai'an Third People's Hospital, Huai'an, China
| | - Heyue Pan
- Department of Neurology, Huai'an Third People's Hospital, Huai'an, China
| | - Chengbing Huang
- Department of Psychiatry, Huai'an Third People's Hospital, Huai'an, China
| | - Taipeng Sun
- Department of Psychiatry, Huai'an Third People's Hospital, Huai'an, China
| | - Shouyong Wang
- Department of Neurology, Huai'an Third People's Hospital, Huai'an, China
| | - Jianyang Xu
- Department of Neurology, Huai'an Third People's Hospital, Huai'an, China
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Krejzar Z, Sila D, Waldauf P, Kuriscak E, Mokrejs P, Spatenkova V. Impact of frailty, biomarkers and basic biochemical parameters on outcomes of comatose patients in status epilepticus: a single-center prospective pilot study. BMC Neurol 2024; 24:46. [PMID: 38279084 PMCID: PMC10811840 DOI: 10.1186/s12883-024-03537-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/14/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Status epilepticus (SE) is a severe acute condition in neurocritical care with high mortality. Searching for risk factors affecting the prognosis in SE remains a significant issue. The primary study's aim was to test the predictive values of the Clinical Frailty Scale (CFS) and the Modified 11-item Frailty Index (mFI-11), the biomarkers and basic biochemical parameters collected at ICU on the Glasgow Outcome Scale (GOS) assessed at hospital discharge (hosp), and three months later (3 M), in comatose patients with SE. The secondary aim was to focus on the association between the patient's state at admission and the duration of mechanical ventilation, the ICU, and hospital stay. METHODS In two years single-centre prospective pilot study enrolling 30 adult neurocritical care patients with SE classified as Convulsive SE, A.1 category according to the International League Against Epilepsy (ILAE) Task Force without an-/hypoxic encephalopathy, we evaluated predictive powers of CFS, mFI-11, admission Status Epilepticus Severity Score (STESS), serum protein S100, serum Troponin T and basic biochemical parameters on prognosticating GOS using univariate linear regression, logistic regression and Receiver Operating Characteristic (ROC) analysis. RESULTS Our study included 60% males, with a mean age of 57 ± 16 years (44-68) and a mean BMI of 27 ± 5.6. We found CFS, mFI-11, STESS, and age statistically associated with GOS at hospital discharge and three months later. Among the biomarkers, serum troponin T level affected GOS hosp (p = 0.027). Serum C-reactive protein significance in prognosticating GOS was found by logistic regression (hosp p = 0.008; 3 M p = 0.004), and serum calcium by linear regression (hosp p = 0.028; 3 M p = 0.015). In relation to secondary outcomes, we found associations between the length of hospital stay and each of the following: age (p = 0.03), STESS (p = 0.009), and serum troponin T (p = 0.029) parameters. CONCLUSIONS This pilot study found promising predictive powers of two frailty scores, namely CFS and mFI-11, which were comparable to age and STESS predictors regarding the GOS at hospital discharge and three months later in ICU patients with SE. Among biomarkers and biochemical parameters, only serum troponin T level affected GOS at hospital discharge.
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Affiliation(s)
- Zdenek Krejzar
- Department of Neurology, First Faculty of Medicine, Charles University in Prague, Katerinska 1660/32, Prague 2, 121 08, Czech Republic
- Centrum of Anaesthesiology, Resuscitation and Intensive Care, Regional Hospital, Husova 357/10, Liberec, 46001, Czech Republic
| | - David Sila
- Centrum of Anaesthesiology, Resuscitation and Intensive Care, Regional Hospital, Husova 357/10, Liberec, 46001, Czech Republic
- Emergency Medical Services, Klasterni 954/5, Liberec, 460 01, Czech Republic
- Faculty of Health Studies, Technical University in Liberec, Studentska 1402/2, 461 17, Liberec 1, Czech Republic
| | - Petr Waldauf
- Department of Anaesthesiology and Resuscitation, Third Faculty of Medicine, Charles University in Prague, Ruska 10, Prague, 100 00, Czechia
- University Hospital Kralovske Vinohrady, 110 34 Prague 10, Srobarova, 1050, Czech Republic
| | - Eduard Kuriscak
- Institute of Physiology, First Faculty of Medicine, Charles University in Prague, Albertov 5, Prague, 128 00, Czech Republic
| | - Petr Mokrejs
- Department of Neurology, First Faculty of Medicine, Charles University in Prague, Katerinska 1660/32, Prague 2, 121 08, Czech Republic
- Emergency Medical Services, Klasterni 954/5, Liberec, 460 01, Czech Republic
| | - Vera Spatenkova
- Faculty of Health Studies, Technical University in Liberec, Studentska 1402/2, 461 17, Liberec 1, Czech Republic.
- Department of Anaesthesiology and Resuscitation, Third Faculty of Medicine, Charles University in Prague, Ruska 10, Prague, 100 00, Czechia.
- University Hospital Kralovske Vinohrady, 110 34 Prague 10, Srobarova, 1050, Czech Republic.
- Institute of Physiology, First Faculty of Medicine, Charles University in Prague, Albertov 5, Prague, 128 00, Czech Republic.
- Neurocenter, Neurointensive Care Unit, Regional Hospital, Husova 357/10, Liberec, 46001, Czech Republic.
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Golcuk Y, Golcuk BK. The role of neutrophil-to-lymphocyte ratio in predicting outcomes in patients with status epilepticus: Considerations beyond CBC. Seizure 2023; 107:189. [PMID: 36906395 DOI: 10.1016/j.seizure.2023.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 02/25/2023] [Indexed: 03/03/2023] Open
Affiliation(s)
- Yalcin Golcuk
- Muğla Sıtkı Koçman University, Faculty of Medicine, Department of Emergency Medicine, Muğla, Turkey.
| | - Burcu Kaymak Golcuk
- Muğla Training and Research Hospital, Clinical Biochemistry Service, Muğla, Turkey
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