Status Epilepticus in Pediatric Patients Severity Score: A Clinical Score to Predict the Outcome of Status Epilepticus in Children - A Cross-sectional Study.
TL;DR
The STEPSS is a useful clinical tool for early prediction of outcome in children with SE, and showed a high Negative predictive value, making it useful in identifying children with a favorable outcome.
Abstract
Background
Status epilepticus (SE) is a life-threatening condition in children, which is associated with significant morbidity and mortality. Early identification of high-risk patients with SE is of utmost importance to improve their outcome. The Status Epilepticus in Pediatric Patients Severity Score (STEPSS) is a simple clinical tool designed to predict the outcome of children with SE.
Objective
The present study aimed to evaluate the clinical utility of the STEPSS score in predicting the outcome in children with SE.
Materials And Methods
This was a cross-sectional study conducted in a pediatric intensive care unit of a tertiary care hospital for a period of 22 months. The study included 50 children aged 1 month to 16 years who presented with seizures for ≥5 min. STEPSS was calculated on admission using clinical parameters. The outcome was assessed by clinical status. Statistical analysis was done using SPSS version 26.
Results
Of the 50 children with SE, 30 (60%) had STEPSS ≥3. Children with a lower STEPSS score (≤2) survived, whereas mortality was observed in 26.7% of those with STEPSS ≥3 (P = 0.0117). Unfavorable neurological outcomes were significantly higher in the ≥3 group. The STEPSS score demonstrated a sensitivity of 100% and specificity of 47.62% for predicting mortality with a diagnostic accuracy of 56%.
Conclusion
The STEPSS is a useful clinical tool for early prediction of outcome in children with SE. Despite high sensitivity and low specificity, the test showed a high Negative predictive value, making it useful in identifying children with a favorable outcome.