Name: Time to First Non-Benzodiazepine Antiseizure Medication in Status Epilepticus
Start: 2026-05-18T10:10:00-0400
End: 2026-05-18T10:30:00-0400

Time to First Non-Benzodiazepine Antiseizure Medication in Status Epilepticus

Monday May 18, 2026 10:10am - 10:30am EDT

a.Pavilion Hub WEST

Evaluate if time to first non-benzodiazepine antiseizure medication (ASM) correlates with the rate of intensive care unit (ICU) admissions in patients presenting with status epilepticus (SE) at Thomas Jefferson University Hospital (TJUH).

This single-center, retrospective chart review included adult patients presenting with SE to the emergency department (ED) at TJUH between April 2022 and April 2024. Records from the electronic health record were reviewed for eligibility. The primary objective was ICU admission rates in patients receiving a non-benzodiazepine ASM <30 vs ≥30 minutes. Secondary outcomes included ED length of stay (LOS), ICU LOS, hospital LOS, progression to refractory SE, cases of intubation, guideline-directed ASM loading dose administered, administration as intravenous (IV) push vs IV piggyback, medication procurement source, and ED pharmacist presence. Categorical variables were analyzed using chi-square or Fisher’s exact tests, and continuous variables using the Mann-Whitney U test. Multiple logistic regression controlling for Acute Physiology and Chronic Health Evaluation II (APACHE II) score and time to ASM administration was conducted.

A total of 202 patient encounters were reviewed, of which 110 met inclusion criteria. Majority of patients were African American males. Among these, 22 encounters received ASM within <30 minutes, with a median APACHE II score of 22.5 and GCS of 4, while 88 encounters received ASM ≥30 minutes, with a median APACHE II of 8.5 and GCS of 9. ICU admission occurred in 86.4% of the <30-minute group and 45.5% of the ≥30-minute group (OR 7.6, 95% CI: 2.1–27, p<0.001). Median time to ASM was 19.5 vs 102 minutes. Median ED LOS was 2.71 vs 4.49 hours, ICU LOS 3.97 vs 0 days, and hospital LOS 7.39 vs 3.73 days, respectively. Higher rates of intubation, full loading doses, and drug procurement via automated dispensing systems were seen in the <30-minute group. Logistic regression showed time to non-benzodiazepine ASM was not associated with ICU admission, but higher APACHE II scores were independently associated (OR 1.272, 95% CI: 1.179–1.398).

Early non-benzodiazepine ASM use was linked to higher ICU admissions, but there was no association after controlling for disease severity. Disease severity, demonstrated by higher APACHE II scores, were independently associated with increased ICU admission rates, particularly in patients receiving ASM <30 minutes. Further studies are needed to clarify the relationship between ASM timing and ICU admissions.

Moderators

Sherif Ahmed

Justin Miller, PharmD

PGY1 RPD & Emergency Medicine Clinical Pharmacist, St. Luke's University Health Network

Speakers

Kerim Cakir, PharmD, MS

PGY1, Thomas Jefferson University Hospital

I completed a BS in Biochemistry from Temple University in 2021 prior to pursuing my PharmD at Temple University School of Pharmacy. During my time there, I also completed a MS in Global Clinical Pharmacovigilance Regulations. Currently, my interests include research, addiction medicine... Read More →

Monday May 18, 2026 10:10am - 10:30am EDT
a.Pavilion Hub WEST

Emergency Medicine

PSHP 2026 Residency Conference

Sherif Ahmed

Justin Miller, PharmD

Kerim Cakir, PharmD, MS

Attendees (19)

Get help with the event

PSHP 2026 Residency Conference

Sherif Ahmed

Justin Miller, PharmD

Kerim Cakir, PharmD, MS

Attendees (19)

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