{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:58:59Z","timestamp":1790675939627,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01NS133037"],"award-info":[{"award-number":["R01NS133037"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Status epilepticus (SE) treatment is more effective when benzodiazepines (BZDs) are given soon after SE diagnosis. The Quality Improvement in Time to Treat Status Epilepticus (QuITT\u2010SE) trial is a multicenter, randomized, stepped\u2010wedge effectiveness\u2010implementation hybrid study aimed at improving time to SE treatment. We report the QuITT\u2010SE baseline cohort and test the hypothesis that acute seizure emergency episodes treated promptly differ in clinical and demographic features from those with delayed treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were summarized from 371 consecutive acute seizures episodes treated with a BZD in the inpatient, non\u2010intensive care unit (ICU) setting from 207 individual patients across eight centers per the QuITT\u2010SE protocol. To test our hypothesis, we utilized a multivariable negative binomial mixed effects model with random intercepts to estimate the incidence rate ratios for variables of interest for time to BZD treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median age was 7\u2009years (IQR\u2009=\u20093\u201312). Nonelective ICU transfers occurred with 26% of episodes, including 13% within 6\u2009h of the episode. The median time from seizure onset to BZD treatment was 6\u2009min (IQR\u2009=\u20094\u201310), with 74% of all episodes and 63% of SE treated within 10\u2009min. BZD administration was faster when nurses made the treatment decision, when the intranasal (IN) route was used, when the patient received prior rescue medication within 24\u2009h, or with certain elective admission types. Seizures were shorter when BZD administration was faster or when treatment was with IN midazolam versus intravenous lorazepam (median\u2009=\u20098\u2009min [IQR =\u20096\u201315] vs. 10\u2009min [IQR\u2009=\u20097\u201317],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.04). Patients were less likely to be transferred to the ICU if they received IN midazolam (odds ratio = .3,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.007).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Delayed BZD administration occurs in one third of SE treatment. Prolonged seizures and ICU transfers are associated with modifiable risk factors. Baseline drivers of delayed acute seizure treatment may be addressed using the QuITT\u2010SE interventions, the study of which is currently ongoing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi.70344","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T15:36:03Z","timestamp":1783092963000},"page":"4551-4560","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with rapid pediatric acute seizure emergency treatment: Quality Improvement in Time to Treat Status Epilepticus baseline cohort"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9994-6650","authenticated-orcid":false,"given":"Adam P.","family":"Ostendorf","sequence":"first","affiliation":[{"name":"Nationwide Children\u2019s Hospital and Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle","family":"Brown\u2010Mitchell","sequence":"additional","affiliation":[{"name":"Nationwide Children\u2019s Hospital and Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2074-0674","authenticated-orcid":false,"given":"Tobias","family":"Loddenkemper","sequence":"additional","affiliation":[{"name":"Boston Children\u2019s Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2206-5561","authenticated-orcid":false,"given":"Lindsey A.","family":"Morgan","sequence":"additional","affiliation":[{"name":"Seattle Children\u2019s Hospital and University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5396-2559","authenticated-orcid":false,"given":"Brian","family":"Appavu","sequence":"additional","affiliation":[{"name":"Honor Health Neurology, Bob Bove Neuroscience Institute  Scottsdale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8717-7703","authenticated-orcid":false,"given":"Raquel","family":"Farias\u2010Moeller","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology, Department of Neurology Children\u2019s Wisconsin and Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6382-8479","authenticated-orcid":false,"given":"Dana","family":"Harrar","sequence":"additional","affiliation":[{"name":"Center for Neuroscience and Behavioral Health Children\u2019s National Hospital, George Washington University  Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4435-206X","authenticated-orcid":false,"given":"Craig","family":"Press","sequence":"additional","affiliation":[{"name":"Departments of Neurology and Pediatrics Children\u2019s Hospital of Philadelphia, University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3586-7080","authenticated-orcid":false,"given":"Janette","family":"Mailo","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Neuroscience Barrow Neurological Institute at Phoenix Children\u2019s Hospital  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6166-2663","authenticated-orcid":false,"given":"Nicholas S.","family":"Abend","sequence":"additional","affiliation":[{"name":"Departments of Neurology and Pediatrics Children\u2019s Hospital of Philadelphia, University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5709-0033","authenticated-orcid":false,"given":"William D.","family":"Gaillard","sequence":"additional","affiliation":[{"name":"Center for Neuroscience and Behavioral Health Children\u2019s National Hospital, George Washington University  Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4999-327X","authenticated-orcid":false,"given":"Shasha","family":"Bai","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4703-4342","authenticated-orcid":false,"given":"Mariah","family":"Eisner","sequence":"additional","affiliation":[{"name":"Biostatics Resource 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