Abstract
Patients that survive status epilepticus (SE) may suffer from neurological and cognitive deficits that cause severe disabilities. An effective scoring system for functional outcome prediction may help the clinician in making treatment decisions for SE patients. Three scoring systems, namely the Status Epilepticus Severity Score (STESS), the Epidemiology-Based Mortality Score in Status Epilepticus (EMSE), and the Encephalitis-Nonconvulsive Status Epilepticus-Diazepam Resistance-Image Abnormalities-Tracheal Intubation (END-IT), have been developed in the past decade to predict the outcomes of patients with SE. Our study aimed at evaluating the effectiveness of these scores in predicting the function outcomes both at and after discharge in SE patients. We retrospectively reviewed the clinical data of 55 patients admitted to our neurological intensive care unit between January 2017 and December 2017. The clinical outcomes at discharge and at last follow-up were graded using the modified Rankin Scale. Our research indicated that STESS was the most sensitive and EMSE was the most specific predictive scoring method for SE outcome prediction. On the other hand, END-IT predicted functional outcomes in SE patients poorly. We concluded that STESS and EMSE can accurately predict the functional outcomes in SE patients both at discharge and the follow-up period.
Highlights
Status epilepticus (SE) is a neurological emergency with a mortality rate ranging between 7.6% and 39% [1]
We examined the effectiveness of currently available scoring systems in the prediction of functional outcomes in SE patients at discharge and approximately one year post-discharge
Our data indicated that Status Epilepticus Severity Score (STESS) was the most sensitive predictive scoring method and Epidemiology-Based Mortality Score in Status Epilepticus (EMSE) was the most specific predictive scoring method for SE outcome predictions
Summary
Status epilepticus (SE) is a neurological emergency with a mortality rate ranging between 7.6% and 39% [1]. Even though several consensus guidelines on SE treatment have been published [2], the prognostic outcome remains suboptimal in SE patients. The aggressiveness of SE management generally depends on the predicted outcome at presentation [3]. For patients with a predicted poor prognostic outcome, vigorous monitoring and aggressive seizure treatment can be performed in order to avoid under-detection or under-treatment of SE. For patients with a predicted good prognostic outcome, a less aggressive therapeutic approach should be adopted in order to avoid potentially harmful over-treatment. This would reduce unnecessary expenditure on medical resources. In order for neurologists to evaluate risks and accurately predict prognostic outcomes in SE patients, an informative and reliable SE outcome prediction method is required
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