TY - JOUR
T1 - Time to Treatment in Pediatric Convulsive Refractory Status Epilepticus
T2 - The Weekend Effect
AU - pSERG
AU - Barcia Aguilar, Cristina
AU - Amengual-Gual, Marta
AU - Sánchez Fernández, Iván
AU - Abend, Nicholas S.
AU - Anderson, Anne
AU - Appavu, Brian
AU - Arya, Ravindra
AU - Brenton, J. Nicholas
AU - Carpenter, Jessica L.
AU - Chapman, Kevin E.
AU - Clark, Justice
AU - Farias-Moeller, Raquel
AU - Gaillard, William D.
AU - Gaínza-Lein, Marina
AU - Glauser, Tracy
AU - Goldstein, Joshua L.
AU - Goodkin, Howard P.
AU - Guerriero, Rejean M.
AU - Huh, Linda
AU - Lai, Yi Chen
AU - McDonough, Tiffani L.
AU - Mikati, Mohamad A.
AU - Morgan, Lyndsey A.
AU - Novotny, Edward J.
AU - Ostendorf, Adam
AU - Payne, Eric T.
AU - Peariso, Katrina
AU - Piantino, Juan
AU - Riviello, James
AU - Sannagowdara, Kumar
AU - Sheehan, Theodore
AU - Sands, Tristan T.
AU - Tasker, Robert C.
AU - Tchapyjnikov, Dmitry
AU - Topjian, Alexis A.
AU - Vasquez, Alejandra
AU - Wainwright, Mark S.
AU - Wilfong, Angus A.
AU - Williams, Korwyn
AU - Loddenkemper, Tobias
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/7
Y1 - 2021/7
N2 - Background: Time to treatment in pediatric refractory status epilepticus is delayed. We aimed to evaluate the influence of weekends and holidays on time to treatment of this pediatric emergency. Methods: We performed a retrospective analysis of prospectively collected observational data of pediatric patients with refractory status epilepticus. Results: We included 329 patients (56% males) with a median (p25 to p75) age of 3.8 (1.3 to 9) years. The median (p25 to p75) time to first BZD on weekdays and weekends/holidays was 20 (6.8 to 48.3) minutes versus 11 (5 to 35) minutes, P = 0.01; adjusted hazard ratio (HR) = 1.20 (95% confidence interval [CI]: 0.95 to 1.55), P = 0.12. The time to first non-BZD ASM was longer on weekdays than on weekends/holidays (68 [42.8 to 153.5] minutes versus 59 [27 to 120] minutes, P = 0.006; adjusted HR = 1.38 [95% CI: 1.08 to 1.76], P = 0.009). However, this difference was mainly driven by status epilepticus with in-hospital onset: among 108 patients, the time to first non-BZD ASM was longer during weekdays than during weekends/holidays (55.5 [28.8 to 103.5] minutes versus 28 [15.8 to 66.3] minutes, P = 0.003; adjusted HR = 1.65 [95% CI: 1.08 to 2.51], P = 0.01). Conclusions: The time to first non-BZD ASM in pediatric refractory status epilepticus is shorter on weekends/holidays than on weekdays, mainly driven by in-hospital onset status epilepticus. Data on what might be causing this difference may help tailor policies to improve medication application timing.
AB - Background: Time to treatment in pediatric refractory status epilepticus is delayed. We aimed to evaluate the influence of weekends and holidays on time to treatment of this pediatric emergency. Methods: We performed a retrospective analysis of prospectively collected observational data of pediatric patients with refractory status epilepticus. Results: We included 329 patients (56% males) with a median (p25 to p75) age of 3.8 (1.3 to 9) years. The median (p25 to p75) time to first BZD on weekdays and weekends/holidays was 20 (6.8 to 48.3) minutes versus 11 (5 to 35) minutes, P = 0.01; adjusted hazard ratio (HR) = 1.20 (95% confidence interval [CI]: 0.95 to 1.55), P = 0.12. The time to first non-BZD ASM was longer on weekdays than on weekends/holidays (68 [42.8 to 153.5] minutes versus 59 [27 to 120] minutes, P = 0.006; adjusted HR = 1.38 [95% CI: 1.08 to 1.76], P = 0.009). However, this difference was mainly driven by status epilepticus with in-hospital onset: among 108 patients, the time to first non-BZD ASM was longer during weekdays than during weekends/holidays (55.5 [28.8 to 103.5] minutes versus 28 [15.8 to 66.3] minutes, P = 0.003; adjusted HR = 1.65 [95% CI: 1.08 to 2.51], P = 0.01). Conclusions: The time to first non-BZD ASM in pediatric refractory status epilepticus is shorter on weekends/holidays than on weekdays, mainly driven by in-hospital onset status epilepticus. Data on what might be causing this difference may help tailor policies to improve medication application timing.
KW - Clinical neurology
KW - Epilepsy
KW - Outcome research
KW - Pediatric
KW - Status epilepticus
UR - http://www.scopus.com/inward/record.url?scp=85107267938&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85107267938&partnerID=8YFLogxK
U2 - 10.1016/j.pediatrneurol.2021.03.009
DO - 10.1016/j.pediatrneurol.2021.03.009
M3 - Article
C2 - 34022752
AN - SCOPUS:85107267938
SN - 0887-8994
VL - 120
SP - 71
EP - 79
JO - Pediatric Neurology
JF - Pediatric Neurology
ER -