Time to Treatment in Pediatric Convulsive Refractory Status Epilepticus: The Weekend Effect
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. We performed a retrospective analysis of prospectively collected observational data of pediatric patients with refrac...
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| Veröffentlicht in: | Pediatric neurology 2021-07, Vol.120, p.71-79 |
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| creator | Barcia Aguilar, Cristina Amengual-Gual, Marta Sánchez Fernández, Iván Abend, Nicholas S. Anderson, Anne Appavu, Brian Arya, Ravindra Brenton, J. Nicholas Carpenter, Jessica L. Chapman, Kevin E. Clark, Justice Farias-Moeller, Raquel Gaillard, William D. Gaínza-Lein, Marina Glauser, Tracy Goldstein, Joshua L. Goodkin, Howard P. Guerriero, Rejean M. Huh, Linda Lai, Yi-Chen McDonough, Tiffani L. Mikati, Mohamad A. Morgan, Lyndsey A. Novotny, Edward J. Ostendorf, Adam Payne, Eric T. Peariso, Katrina Piantino, Juan Riviello, James Sannagowdara, Kumar Sheehan, Theodore Sands, Tristan T. Tasker, Robert C. Tchapyjnikov, Dmitry Topjian, Alexis A. Vasquez, Alejandra Wainwright, Mark S. Wilfong, Angus A. Williams, Korwyn Loddenkemper, Tobias |
| description | 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.
We performed a retrospective analysis of prospectively collected observational data of pediatric patients with refractory status epilepticus.
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).
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. |
| doi_str_mv | 10.1016/j.pediatrneurol.2021.03.009 |
| format | Article |
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We performed a retrospective analysis of prospectively collected observational data of pediatric patients with refractory status epilepticus.
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).
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.</description><identifier>ISSN: 0887-8994</identifier><identifier>EISSN: 1873-5150</identifier><identifier>DOI: 10.1016/j.pediatrneurol.2021.03.009</identifier><identifier>PMID: 34022752</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Anticonvulsants - administration & dosage ; Benzodiazepines - administration & dosage ; Child ; Child, Preschool ; Clinical neurology ; Drug Resistant Epilepsy - drug therapy ; Epilepsy ; Female ; Humans ; Infant ; Male ; Outcome and Process Assessment, Health Care ; Outcome research ; Pediatric ; Status epilepticus ; Status Epilepticus - drug therapy ; Time Factors ; Time-to-Treatment</subject><ispartof>Pediatric neurology, 2021-07, Vol.120, p.71-79</ispartof><rights>2021 Elsevier Inc.</rights><rights>Copyright © 2021 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c383t-86b51b0f8a9d3c0d1ef8758b2a595517d6e9c5d645178ba0d8693c9bc91ee7a43</citedby><cites>FETCH-LOGICAL-c383t-86b51b0f8a9d3c0d1ef8758b2a595517d6e9c5d645178ba0d8693c9bc91ee7a43</cites><orcidid>0000-0001-7788-6661 ; 0000-0003-1616-8329 ; 0000-0001-9275-9054 ; 0000-0001-7285-1195 ; 0000-0003-2206-5561 ; 0000-0001-9432-1347 ; 0000-0002-6887-3495 ; 0000-0003-3076-3298 ; 0000-0002-8059-9388 ; 0000-0003-0873-9718 ; 0000-0002-9450-5506 ; 0000-0001-8717-7703 ; 0000-0001-7639-2504 ; 0000-0002-4719-6683</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.pediatrneurol.2021.03.009$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34022752$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Barcia Aguilar, Cristina</creatorcontrib><creatorcontrib>Amengual-Gual, Marta</creatorcontrib><creatorcontrib>Sánchez Fernández, Iván</creatorcontrib><creatorcontrib>Abend, Nicholas S.</creatorcontrib><creatorcontrib>Anderson, Anne</creatorcontrib><creatorcontrib>Appavu, Brian</creatorcontrib><creatorcontrib>Arya, Ravindra</creatorcontrib><creatorcontrib>Brenton, J. Nicholas</creatorcontrib><creatorcontrib>Carpenter, Jessica L.</creatorcontrib><creatorcontrib>Chapman, Kevin E.</creatorcontrib><creatorcontrib>Clark, Justice</creatorcontrib><creatorcontrib>Farias-Moeller, Raquel</creatorcontrib><creatorcontrib>Gaillard, William D.</creatorcontrib><creatorcontrib>Gaínza-Lein, Marina</creatorcontrib><creatorcontrib>Glauser, Tracy</creatorcontrib><creatorcontrib>Goldstein, Joshua L.</creatorcontrib><creatorcontrib>Goodkin, Howard P.</creatorcontrib><creatorcontrib>Guerriero, Rejean M.</creatorcontrib><creatorcontrib>Huh, Linda</creatorcontrib><creatorcontrib>Lai, Yi-Chen</creatorcontrib><creatorcontrib>McDonough, Tiffani L.</creatorcontrib><creatorcontrib>Mikati, Mohamad A.</creatorcontrib><creatorcontrib>Morgan, Lyndsey A.</creatorcontrib><creatorcontrib>Novotny, Edward J.</creatorcontrib><creatorcontrib>Ostendorf, Adam</creatorcontrib><creatorcontrib>Payne, Eric T.</creatorcontrib><creatorcontrib>Peariso, Katrina</creatorcontrib><creatorcontrib>Piantino, Juan</creatorcontrib><creatorcontrib>Riviello, James</creatorcontrib><creatorcontrib>Sannagowdara, Kumar</creatorcontrib><creatorcontrib>Sheehan, Theodore</creatorcontrib><creatorcontrib>Sands, Tristan T.</creatorcontrib><creatorcontrib>Tasker, Robert C.</creatorcontrib><creatorcontrib>Tchapyjnikov, Dmitry</creatorcontrib><creatorcontrib>Topjian, Alexis A.</creatorcontrib><creatorcontrib>Vasquez, Alejandra</creatorcontrib><creatorcontrib>Wainwright, Mark S.</creatorcontrib><creatorcontrib>Wilfong, Angus A.</creatorcontrib><creatorcontrib>Williams, Korwyn</creatorcontrib><creatorcontrib>Loddenkemper, Tobias</creatorcontrib><creatorcontrib>pSERG</creatorcontrib><title>Time to Treatment in Pediatric Convulsive Refractory Status Epilepticus: The Weekend Effect</title><title>Pediatric neurology</title><addtitle>Pediatr Neurol</addtitle><description>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.
We performed a retrospective analysis of prospectively collected observational data of pediatric patients with refractory status epilepticus.
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).
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.</description><subject>Anticonvulsants - administration & dosage</subject><subject>Benzodiazepines - administration & dosage</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Clinical neurology</subject><subject>Drug Resistant Epilepsy - drug therapy</subject><subject>Epilepsy</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Outcome and Process Assessment, Health Care</subject><subject>Outcome research</subject><subject>Pediatric</subject><subject>Status epilepticus</subject><subject>Status Epilepticus - drug therapy</subject><subject>Time Factors</subject><subject>Time-to-Treatment</subject><issn>0887-8994</issn><issn>1873-5150</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE1rFTEUhoMo9lr9CxJw42amJ8lkJtGVXG61ULDUKy5chEzmDOY6XyaZC_33ptwqdNfVOYv3g_ch5B2DkgGrLw7lgp23KUy4hnkoOXBWgigB9DOyYaoRhWQSnpMNKNUUSuvqjLyK8QAAUvPqJTkTFXDeSL4hP_d-RJpmug9o04hTon6iN6cC7-h2no7rEP0R6S32wbo0hzv6Ldm0Rrpb_IBL8m6NH-j-F9IfiL9x6uiu79Gl1-RFb4eIbx7uOfl-udtvvxTXXz9fbT9dF04okQpVt5K10CurO-GgY9irRqqWW6mlZE1Xo3ayq6v8q9ZCp2otnG6dZoiNrcQ5eX_KXcL8Z8WYzOijw2GwE85rNFwKxvNeEFn68SR1YY4xYG-W4Ecb7gwDc0_XHMwjuuaergFhMt3sfvtQtLYjdv-9_3Bmwe4kwDz36DGY6DxOLieGDMR0s39S0V-355QW</recordid><startdate>202107</startdate><enddate>202107</enddate><creator>Barcia Aguilar, Cristina</creator><creator>Amengual-Gual, Marta</creator><creator>Sánchez Fernández, Iván</creator><creator>Abend, Nicholas S.</creator><creator>Anderson, Anne</creator><creator>Appavu, Brian</creator><creator>Arya, Ravindra</creator><creator>Brenton, J. 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Nicholas ; Carpenter, Jessica L. ; Chapman, Kevin E. ; Clark, Justice ; Farias-Moeller, Raquel ; Gaillard, William D. ; Gaínza-Lein, Marina ; Glauser, Tracy ; Goldstein, Joshua L. ; Goodkin, Howard P. ; Guerriero, Rejean M. ; Huh, Linda ; Lai, Yi-Chen ; McDonough, Tiffani L. ; Mikati, Mohamad A. ; Morgan, Lyndsey A. ; Novotny, Edward J. ; Ostendorf, Adam ; Payne, Eric T. ; Peariso, Katrina ; Piantino, Juan ; Riviello, James ; Sannagowdara, Kumar ; Sheehan, Theodore ; Sands, Tristan T. ; Tasker, Robert C. ; Tchapyjnikov, Dmitry ; Topjian, Alexis A. ; Vasquez, Alejandra ; Wainwright, Mark S. ; Wilfong, Angus A. ; Williams, Korwyn ; Loddenkemper, Tobias</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c383t-86b51b0f8a9d3c0d1ef8758b2a595517d6e9c5d645178ba0d8693c9bc91ee7a43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Anticonvulsants - administration & dosage</topic><topic>Benzodiazepines - administration & dosage</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Clinical neurology</topic><topic>Drug Resistant Epilepsy - drug therapy</topic><topic>Epilepsy</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Male</topic><topic>Outcome and Process Assessment, Health Care</topic><topic>Outcome research</topic><topic>Pediatric</topic><topic>Status epilepticus</topic><topic>Status Epilepticus - drug therapy</topic><topic>Time Factors</topic><topic>Time-to-Treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Barcia Aguilar, Cristina</creatorcontrib><creatorcontrib>Amengual-Gual, Marta</creatorcontrib><creatorcontrib>Sánchez Fernández, Iván</creatorcontrib><creatorcontrib>Abend, Nicholas S.</creatorcontrib><creatorcontrib>Anderson, Anne</creatorcontrib><creatorcontrib>Appavu, Brian</creatorcontrib><creatorcontrib>Arya, Ravindra</creatorcontrib><creatorcontrib>Brenton, J. 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Nicholas</au><au>Carpenter, Jessica L.</au><au>Chapman, Kevin E.</au><au>Clark, Justice</au><au>Farias-Moeller, Raquel</au><au>Gaillard, William D.</au><au>Gaínza-Lein, Marina</au><au>Glauser, Tracy</au><au>Goldstein, Joshua L.</au><au>Goodkin, Howard P.</au><au>Guerriero, Rejean M.</au><au>Huh, Linda</au><au>Lai, Yi-Chen</au><au>McDonough, Tiffani L.</au><au>Mikati, Mohamad A.</au><au>Morgan, Lyndsey A.</au><au>Novotny, Edward J.</au><au>Ostendorf, Adam</au><au>Payne, Eric T.</au><au>Peariso, Katrina</au><au>Piantino, Juan</au><au>Riviello, James</au><au>Sannagowdara, Kumar</au><au>Sheehan, Theodore</au><au>Sands, Tristan T.</au><au>Tasker, Robert C.</au><au>Tchapyjnikov, Dmitry</au><au>Topjian, Alexis A.</au><au>Vasquez, Alejandra</au><au>Wainwright, Mark S.</au><au>Wilfong, Angus A.</au><au>Williams, Korwyn</au><au>Loddenkemper, Tobias</au><aucorp>pSERG</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Time to Treatment in Pediatric Convulsive Refractory Status Epilepticus: The Weekend Effect</atitle><jtitle>Pediatric neurology</jtitle><addtitle>Pediatr Neurol</addtitle><date>2021-07</date><risdate>2021</risdate><volume>120</volume><spage>71</spage><epage>79</epage><pages>71-79</pages><issn>0887-8994</issn><eissn>1873-5150</eissn><abstract>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.
We performed a retrospective analysis of prospectively collected observational data of pediatric patients with refractory status epilepticus.
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).
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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34022752</pmid><doi>10.1016/j.pediatrneurol.2021.03.009</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-7788-6661</orcidid><orcidid>https://orcid.org/0000-0003-1616-8329</orcidid><orcidid>https://orcid.org/0000-0001-9275-9054</orcidid><orcidid>https://orcid.org/0000-0001-7285-1195</orcidid><orcidid>https://orcid.org/0000-0003-2206-5561</orcidid><orcidid>https://orcid.org/0000-0001-9432-1347</orcidid><orcidid>https://orcid.org/0000-0002-6887-3495</orcidid><orcidid>https://orcid.org/0000-0003-3076-3298</orcidid><orcidid>https://orcid.org/0000-0002-8059-9388</orcidid><orcidid>https://orcid.org/0000-0003-0873-9718</orcidid><orcidid>https://orcid.org/0000-0002-9450-5506</orcidid><orcidid>https://orcid.org/0000-0001-8717-7703</orcidid><orcidid>https://orcid.org/0000-0001-7639-2504</orcidid><orcidid>https://orcid.org/0000-0002-4719-6683</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0887-8994 |
| ispartof | Pediatric neurology, 2021-07, Vol.120, p.71-79 |
| issn | 0887-8994 1873-5150 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2531222703 |
| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Anticonvulsants - administration & dosage Benzodiazepines - administration & dosage Child Child, Preschool Clinical neurology Drug Resistant Epilepsy - drug therapy Epilepsy Female Humans Infant Male Outcome and Process Assessment, Health Care Outcome research Pediatric Status epilepticus Status Epilepticus - drug therapy Time Factors Time-to-Treatment |
| title | Time to Treatment in Pediatric Convulsive Refractory Status Epilepticus: The Weekend Effect |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-08T03%3A18%3A20IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Time%20to%20Treatment%20in%20Pediatric%20Convulsive%20Refractory%20Status%20Epilepticus:%20The%20Weekend%20Effect&rft.jtitle=Pediatric%20neurology&rft.au=Barcia%20Aguilar,%20Cristina&rft.aucorp=pSERG&rft.date=2021-07&rft.volume=120&rft.spage=71&rft.epage=79&rft.pages=71-79&rft.issn=0887-8994&rft.eissn=1873-5150&rft_id=info:doi/10.1016/j.pediatrneurol.2021.03.009&rft_dat=%3Cproquest_cross%3E2531222703%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2531222703&rft_id=info:pmid/34022752&rft_els_id=S0887899421000552&rfr_iscdi=true |