Evaluation of the Status Epilepticus Severity Score (STESS) as a predictor of in-hospital mortality in patients with status epilepticus: a retrospective observational study
Keywords:mortality, status epilepticus, status epilepticus severity score
Background. Status epilepticus (SE) is a medical emergency characterized by continuous or recurrent epileptic activity with high mortality. The STESS (Status Epilepticus Severity Score) allows evaluating the prognosis of patients with EE, however, it has not been validated in Mexico, nor has it been established whether its cut-off points are similar to those of the original study. Objective. To describe the clinical characteristics of patients with EE in our center, to determine the variables associated with mortality and the predictive capacity of the STESS for in-hospital mortality. Material and methods. Retrospective cohort study. 60 patients diagnosed with EE during the 2000-2020 period were included and the STESS was applied. Data on clinical characteristics and in-hospital mortality were obtained. A Cox regression analysis was performed to determine the risk of mortality for each point on the scale, and the area under the ROC curve was calculated to determine its discrimination capacity. Results. The predominant clinical presentation was generalized convulsive status epilepticus (51.7%); the most frequent etiologies were acute symptomatic (46.7%). In-hospital mortality was 40%. The risk of mortality increases 38% for each STESS point (B=0.38, HR=1.48, 95%CI:1.13-1.94, p=0.005). The area under the ROC curve was 0.72 with an optimal cut-off point of ≥3 points for discrimination of in-hospital mortality. Conclusions. The STESS is significantly associated with in-hospital mortality and can be used as a predictor of adverse outcomes in patients with SE.
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September 2022-present © Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez. Open access articles under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) license, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. No commercial re-use is allowed.
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January 2014-December 2021 © Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez. Open access articles under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) license, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.