Risk factors for recurrent status epilepticus

Background and Rationale: Status epilepticus (SE) is associated with substantial morbidity and mortality. A proportion of patients experience recurrent episodes, but the clinical factors associated with recurrence are incompletely understood. Identifying patients at increased risk may facilitate closer monitoring, optimization of antiseizure treatment, and early intervention. Research Question: What are the predictors and risk factors for recurrent status epilepticus? Methods: This will be a retrospective observational cohort study of consecutive patients presenting with status epilepticus. Demographic, clinical, aetiological, EEG, neuroimaging, and treatment-related variables will be extracted from medical records. Potential predictors will include age, sex, epilepsy history, previous SE, seizure frequency, antiseizure medication use and adherence, aetiology of SE, acute symptomatic precipitants, seizure type, duration of SE, level of consciousness, EEG characteristics, and treatment requirements, including the number of antiseizure medications and use of anaesthetic agents. Patients will be followed for a predefined period to identify subsequent episodes of SE. Analysis and Prediction Model: Predictors of recurrent SE will initially be evaluated using univariable analyses, followed by multivariable logistic regression to identify independent risk factors. A prediction model will then be developed using clinically relevant independent predictors. The final model will be converted into a clinically applicable risk score for estimating an individual patient's risk of recurrent SE.