{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T07:12:40Z","timestamp":1774422760916,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["U01NS088034"],"award-info":[{"award-number":["U01NS088034"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["U01NS088023"],"award-info":[{"award-number":["U01NS088023"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["U01NS056975"],"award-info":[{"award-number":["U01NS056975"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["U01NS059041"],"award-info":[{"award-number":["U01NS059041"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["U01NS073476"],"award-info":[{"award-number":["U01NS073476"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Status epilepticus (SE) is a medical emergency requiring rapid intervention. Despite treatment guidelines, delays in real\u2010world SE management persist, potentially worsening outcomes. The Established Status Epilepticus Treatment Trial (ESETT), while comparing second\u2010line antiseizure medications, also enabled analysis of treatment timelines in emergency settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study evaluates the timing of SE treatment steps in ESETT to assess adherence to guideline\u2010recommended timeframes and identify factors contributing to delays.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This secondary analysis of ESETT included patients aged \u2265\u20092\u2009years with generalized convulsive SE unresponsive to benzodiazepines, randomized to receive fosphenytoin, levetiracetam, or valproic acid. Key intervals analyzed included time from emergency department (ED) arrival to first benzodiazepine, initiation of second\u2010line therapy, and other interventions (e.g., intubation, rescue meds). We used descriptive statistics and the Van Elteren test to compare timelines between those who achieved treatment success, defined as seizure cessation and improved mental status at 60\u2009min, and those who did not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 487 patients (53% adults, 47% children; 57% male), 46% achieved treatment success. Nearly half did not receive any prehospital benzodiazepines. Median time from ED arrival to first benzodiazepine was 11\u2009min (IQR 5\u201341), and to second\u2010line antiseizure medications was 26\u2009min (IQR 18\u201343), both generally aligning with guidelines. Earlier administration of second\u2010line therapy was significantly associated with treatment success (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although many treatment steps occurred within recommended windows, considerable variability exists. Prehospital benzodiazepine use was often absent, and in\u2010hospital treatment timing was inconsistent. Earlier delivery of second\u2010line therapy correlated with improved outcomes. These real\u2010world data provide a lens through which to better understand the causes and impact of practice variability in time to treatment and assess the extent to which current guidelines on timing may be important, but also how they may be ambiguous or unrealistic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acem.70265","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T14:40:22Z","timestamp":1773931222000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Chronological Sequence of Convulsive Status Epilepticus Treatment Steps in a Real\u2010Life Scenario for Patients Enrolled in a Large Multicenter Trial"],"prefix":"10.1111","volume":"33","author":[{"given":"Shahriar","family":"Zehtabchi","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine New York City Health + Hospitals\/Kings County  Brooklyn New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Beall","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Silbergleit","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerie","family":"Durkalski\u2010Mauldin","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric S.","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Department of Neurology, NeuroAI Center Mass General Brigham  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James M.","family":"Chamberlain","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine Children's National Hospital  Washington DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas P.","family":"Bleck","sequence":"additional","affiliation":[{"name":"Davee Department of Neurology Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Cloyd","sequence":"additional","affiliation":[{"name":"Center for Orphan Drug Research College of Pharmacy, University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Quigg","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Virginia  Charlottesville VA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Valsamis","sequence":"additional","affiliation":[{"name":"Department of Neurology New York City Health + Hospitals\/Kings County  Brooklyn New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaideep","family":"Kapur","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Virginia  Charlottesville VA 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