Incidence of infections in patients with status epilepticus requiring intensive care and effect on resource utilization

Data from a six-year period were retrospectively retrieved from medical records and an intensive care unit data management system to study the impact of infections on patients with status epilepticus. Out of 161 admitted patients, 33 had a community-acquired infection and 35 acquired an infection during their hospital stay, 10 while in a ward before admission to the intensive care unit and 25 while in an intensive care unit, giving an infection rate of 42% of all admissions (68 patients). The patients with intensive care unit-acquired infection had three times longer stays in the intensive care unit than those without any infection (P < 0.001), and they utilized almost four times more nursing resources than those without infections (P < 0.001). Furthermore, they were more often sedated with thiopentone infusion, either alone or in combination with other drugs, than the non-infectious patients (80% vs 20%, P < 0.001). Both community- and hospital-acquired infections were related to longer intensive care unit stays (P < 0.001). The hospital stay of patients with hospital-acquired infection was threefold compared to that of patients without infection (P < 0.001), and these patients utilized almost three times more nursing resources than those without any infection (P < 0.001). Patients with infections consumed 65.5% of the intensive care unit nursing resources of status epilepticus patients. In conclusion, the infection rate of status epilepticus patients was high and nosocomial infections were associated with more severe illness, treatment escalation, prolonged hospital stay and enhanced resource utilization.