Prediction of 3-month functional outcome of status epilepticus: Is END-IT scale sufficient to help?
TL;DR
In this SE cohort, END-IT showed moderate prognostic performance for predicting 3-month functional outcomes and incorporation of comorbidity burden may enhance future prognostic models.
Abstract
Background
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Objectives
Status epilepticus (SE) poses high risks of death and disability, yet most prognostic tools focus solely on mortality. The END-IT score is the only scale specifically developed to predict 3-month functional outcomes of SE. Hence, this study evaluated the performance of END-IT in adults with SE and explored additional predictors of 3-month functional outcomes.
Methods
This prospective cohort study was conducted at a tertiary hospital in Egypt (August 2024-August 2025). Data collected included demographics, the Charlson Comorbidity Index (CCI), initial level of consciousness (as measured by the Glasgow Coma Scale [GCS] and FOUR score), seizure semiology, SE refractoriness, Status Epilepticus Severity Score (STESS), and all END-IT components. An unfavourable outcome was defined as a Modified Rankin Scale (mRS) score of 3-6 at the 3-month follow-up.
Results
A total of 114 patients were enrolled (median age 33 years [IQR 17.75-54.25]). Most episodes were convulsive SE, while non-convulsive SE accounted for 4.4%. At 3 months, 55.3% had unfavourable outcomes, including 36.8% deaths. The sensitivity and specificity for unfavourable outcome prediction after 3 months for END-IT (≥3) = 0.524 and 0.843, respectively (Area under the curve = 0.747). The regression model revealed that higher CCI scores (OR = 2.06, 95% CI: 1.31-3.23, P = 0.002) and higher END-IT scores (OR = 1.67, 95% CI: 1.12-2.49, P = 0.013) were independently associated with unfavourable outcomes.
Conclusion
In this SE cohort, END-IT showed moderate prognostic performance for predicting 3-month functional outcomes. Incorporating comorbidity burden may enhance future prognostic models.