昼夜节律
医学
癫痫
节奏
癫痫持续状态
逻辑回归
回顾性队列研究
重症监护医学
药理学
儿科
内科学
精神科
作者
Nan Cheng,Jing-Han Liu,Xuxian Kan,Jiangyu Wang,Zhenliang Hui,Jun Chen
标识
DOI:10.1093/qjmed/hcae167
摘要
Abstract Background The progression from isolated seizures to status epilepticus (SE) is a critical clinical issue. This study explores the influence of circadian rhythms on this transition and assesses the impact of medication timing on SE conversion rates and patient survival. Aim To determine the circadian patterns in the transition from isolated seizures to SE and to evaluate the efficacy of medication timing in reducing this conversion and improving survival outcomes. Design and Methods Utilizing the eICU Collaborative Research Database v2.0, a retrospective analysis was performed on patients at risk of SE conversion. The study analyzed the correlation between SE conversion timing and AEDs administration in relation to circadian rhythms, employing a Logit model to evaluate the impact of medication timing on SE conversion and survival. Results The transition from isolated seizures to SE showed distinct circadian patterns, with a delayed acrophase. Early night-time AEDs administration significantly reduced conversion rates. Medication timing also influenced survival rates, with higher survival during specific periods. Conclusion Circadian rhythms significantly affect the transition from isolated seizures to SE. Timely AEDs administration is crucial for reducing conversions and improving survival. A chronotherapeutic approach aligning AEDs administration with individual circadian vulnerabilities could advance epilepsy management in ICU settings. Future research should focus on personalized medication strategies that utilize circadian rhythms to optimize treatment effects.
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