Outcome of status epilepticus and the predictive value of the EMSE and STESS scores: A prospective study
| Autor: | Harri T. Hyppölä, Reetta Kälviäinen, Joni J. Sairanen, Anne-Mari Kantanen |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Comorbidity Status epilepticus Severity of Illness Index Cohort Studies Young Adult 03 medical and health sciences Status Epilepticus 0302 clinical medicine Internal medicine Epidemiology Humans Medicine Prospective Studies Prospective cohort study Finland Aged Aged 80 and over business.industry Medical record Age Factors Electroencephalography General Medicine Emergency department Middle Aged Prognosis medicine.disease Treatment Outcome Neurology Cohort Etiology Female Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Seizure. 75:115-120 |
| ISSN: | 1059-1311 |
| DOI: | 10.1016/j.seizure.2019.12.026 |
| Popis: | Purpose To assess the short-term outcome of status epilepticus (SE) and test the Epidemiology-based Mortality score in Status Epilepticus (EMSE) and the Status Epilepticus Severity Score (STESS) performance in outcome prediction. Methods Consecutive adults with SE in the Kuopio University Hospital emergency department were recruited between March 23 and December 31, 2015. The one-month outcome was assessed by a combined phone interview and medical record review using the Glasgow Outcome Scale-Extended. The prognostic performance of the EMSE-EAC (EMSE using the combination of etiology, age and comorbidity) and STESS were statistically evaluated. Results We recorded 151 SE episodes in 137 patients, of whom 47 had a first-time epileptic event (seizure or SE). Of the SE episodes, 9.0% resulted in death, 31.6% in functional decline. For mortality prediction, the AUCs of the EMSE-EAC and STESS were 0.790 (95% CI: 0.633–0.947) and 0.736 (95% CI: 0.559–0.914), respectively. The optimal cutoff points were ≥ 34 for the EMSE-EAC and ≥ 4 for STESS. Negative predictive values for mortality using the EMSE-EAC-34 and STESS-4 were 97.5% and 96.7%, respectively. For functional decline prediction, the EMSE-EAC yielded statistically insignificant results, the STESS performance was poor (AUC = 0.621, 95% CI: 0.519–0.724). Conclusions Over 40% of SE patients suffer adverse outcomes. The EMSE-EAC and STESS are useful in short-term mortality prediction, with a high negative predictive value. The optimized cutoff points for the EMSE-EAC and STESS were ≥ 34 and ≥ 4 for cohort, respectively. |
| Databáze: | OpenAIRE |
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