*2.6. Statistical Analysis*

Categorical variables were expressed as numbers and percentages and were compared with the use of ordinal chi-squared or Fisher's exact tests, as appropriate. Continuous variables were expressed as medians (interquartile ranges) and were compared with the use of a *t*-test, Welch's test, or Wilcoxon signed-rank test, as appropriate. A Shapiro–Wilk test was used to distinguish between normal and abnormal distributions.

Logistic multivariable analysis was performed for the occurrence of BAP. To avoid overfitting, only variables with *p*-values under 0.10 in the univariate analysis were considered for inclusion in the final model. Multicollinearity was assessed using variance inflation factor with a cut-off at 4. Clinical relevance of variables was discussed. The fitness was evaluated by Negelkerke's R2.

All tests were two sided, and the statistical significance was defined by *p*-values under 0.05. Statistical analyses were performed with R statistical software, version 3.6.0 [13].

#### **3. Results**

From January 2013 to February 2022, 246 patients were screened for eligibility. Among them, 20 patients with postanoxic SE were excluded. Two hundred and twenty-six patients were admitted to ICU with generalized convulsive SE requiring MV (Figure 1).

**Figure 1.** Flowchart. Abbreviations: SE, status epilepticus.

#### *3.1. Patient Characteristics*

The median age was 55 years (interquartile range, 43 to 68), and 146 (65%) patients were males. A total of 109 (48%) patients had a history of epilepsy and 40 (18%) of previous SE. Fifty-five (24%) patients were considered as refractory status epilepticus. According to ILAE's etiologic categories, 71 (31%) patients had a SE related to an acute brain injury, 104 (46%) to previous and stable brain lesion (remote symptomatic), 31 (14%) to a progressive brain injury, and 14 (6%) patients had an SE of unknown origin (Table 1).


 syndrome.


**Table 1.** *Cont.*

#### *3.2. Comparison of Patients with and without Aspiration Syndrome*

One hundred and three patients (46%) met the criteria for aspiration syndrome. Of note, considering the overall cohort, these criteria were frequently found during the first 48 h of MV: 147 (66%) had abnormal body temperature, 160 (72%) had purulent tracheal aspirates, and 171 (77%) had leukocytosis.

At admission, patients with aspiration syndrome had more frequently persistent seizures (*p* = 0.001). Body temperature was similar (*p* = 0.90) and heart rate was higher in patients with aspiration syndrome (*p* = 0.01). No other baseline characteristics differed, especially SE characteristics and etiology. Interestingly, macroaspiration (*p* = 0.50) and timing (*p* = 0.53) or reason (*p* = 0.54) for intubation were not associated with aspiration syndrome (Table 1).

Regarding laboratory results, patients with aspiration syndrome had a lower Pa02/Fi02 ratio (*p* < 0.001), a higher serum level of CRP (*p* < 0.01), and a lower serum level of albumin (*p* = 0.03). No difference was found for serum blood level of PCT (*p* = 0.13) and leukocyte count (*p* = 0.54) (Table 1).

Aspiration syndrome was associated with a longer MV duration (*p* < 0.01) and ICU length of stay (*p* = 0.01). Three-month mortality (*p* = 0.43) and poor functional outcome (*p* = 0.36) did not differ between groups (Table 1).

#### *3.3. Comparison of Patients with BAP versus Pneumonitis*

Among patients with aspiration syndrome, 12 (5%) did not have endotracheal aspirate and could not be classified as BAP or pneumonitis. These patients were excluded for analysis concerning BAP and pneumonitis (Figure 1). Fifty-four patients (59%) had a BAP, whereas others were considered as pneumonitis. Considering the overall cohort, 24% of patients with GCSE presented a BAP.

Patients with BAP, in comparison with pneumonitis, were less likely alcoholic (*p* = 0.02) and had a higher SAPS II at admission (*p* = 0.03). No other baseline characteristics differed, especially SE characteristics and etiology (Table 2).


**Table 2.** Comparison of patients' characteristics according to the diagnosis of BAP or pneumonitis.


#### **Table 2.** *Cont.*

Categorical variables were expressed as number (percentage) and compared by a chi-squared test or Fisher's exact test when specified by \*. Continuous variables were expressed as median (inter-quartile range), and a *t*-test was performed (Welch or Wilcoxon tests, as appropriate). Missing values (BAP; pneumonitis): CRP, 6 (5;1); PCT, 19 (12;7); albumin, 7 (3;4); lactate arterial, 1 (0;1). Abbreviations: BAP, bacterial aspiration pneumonia; mRS, modified Rankin scale; SAPS II, simplified acute physiology score; ICU, intensive care unit; CRP, C-reactive protein; PCT, procalcitonin.

We found no difference concerning serum levels of CRP (*p* = 0.78), PCT (*p* = 0.87), and albumin (*p* = 0.41) between patients with BAP and pneumonitis. The severity of hypoxia estimated by the Pa02/Fi02 ratio and arterial lactate level did not differ between groups (respectively, *p* = 0.34 and *p* = 0.31) (Table 2).

We did not perform a multivariable analysis due to the absence of clinical relevance.
