Comparison of the Three Scoring Models (STEPSS, MSTEPSS, and END-IT) for Outcome Characteristics in a Pediatric Status Epilepticus Cohort

Background: Various scoring models have been developed to predict outcomes in pediatric status epilepticus (SE) OBJECTIVES: To compare a set of scoring models for predictivity of outcome characteristics in a single-center pediatric SE cohort.

Patients And Methods: Three SE scoring models (STEPSS, mSTEPSS, and END-IT) were retrospectively evaluated for outcome characteristics in a cohort including 240 children. The areas under curves (AUC) were calculated for the models: short-term outcome with in-hospital mortality, progression to refractory / super-refractory SE, poor outcome at hospital discharge with modified Rankin scale (mRS), and long-term functional outcome with the scores of pediatric overall performance category (POPC) scale at 2-years of follow-up.

Results: The mean age was 64.8 ± 53.9 (1-216) months and 59.2 % of the patients were male. The refractory or super-refractory SE was observed in 100 patients of 240 (41.7 %) patients. A non-convulsive status epilepticus developed in 2.1 % (n = 5) of the patients during follow-up. Fifty-seven patients (23.7 %) received a new diagnosis of epilepsy. In-hospital mortality was 2.5 % in the whole cohort. A poor primary outcome was defined in 64 (26.7 %) with a POPC score ≥ 3. Among three scoring models, the END-IT provided a moderate predictivity for in-hospital mortality, progression to refractory/super-refractory SE, poor outcome at hospital discharge with mRS, and POPC score ≥ 3, AUCs were 0.815, 0.715, 0.742 and 0.720, respectively.

Conclusion: The END-IT scoring model is a practical and reliable tool for outcome prediction in the intensive care unit as well as the poor outcome at hospital discharge and functional outcome at 2 years of follow-up.