Status epilepticus in the prehospital setting: treatment gaps and their association with hospital course.
Only 19% of status epilepticus patients received guideline-consistent first-line prehospital treatment.
Status epilepticus in the prehospital setting: treatment gaps and their association with hospital course.
Status epilepticus (SE) is a time-critical neurological emergency associated with significant morbidity and mortality, making timely recognition and treatment particularly crucial.
We aimed to evaluate whether prehospital factors were associated with in-hospital outcomes in a Lithuanian cohort.
We conducted a two-center retrospective observational study of adult SE episodes transported by emergency medical services (emergency medical services) to two tertiary hospitals in Lithuania between 2015 and 2024.
most patients did not get recommended emergency seizure treatment
Median time from emergency medical services call to benzodiazepines initiation was 16 min (IQR=12-26), to start of transportation - 40 min (IQR=32-53).
Longer time to first-line benzodiazepines treatment was linked to institutional rather than home discharge (aOR 1.038, 95% CI 1.011 to 1.066, p = 0.006).
Prolonged time to transport initiation was independently associated with total hospital (B = 141.1, 95% CI 39.0 to 243.2, p = 0.007) and intensive care unit length of stay (B = 91.7, 95% CI 33.4 to 150.1, p = 0.002).
Prehospital time intervals emerged as the main potentially modifiable factors associated with in-hospital outcomes in SE.
Frequent benzodiazepines undertreatment and non-recommended route use highlight gaps in guideline adherence in routine prehospital care.