Evaluation of the Status Epilepticus Severity Score (STESS) as a predictor of in-hospital mortality in patients with status epilepticus: a retrospective observational study

Authors

  • José de Jesús Vidal-Mayo Department of Continuous Institutional Care and Emergencies, Salvador Zubirán National Institute of Medical Sciences and Nutrition (INCMNSZ), Mexico City, Mexico. https://orcid.org/0000-0001-9345-9053
  • Uriel Guzmán Ramírez Department of Continuous Institutional Care and Emergencies, Salvador Zubirán National Institute of Medical Sciences and Nutrition (INCMNSZ), Mexico City, Mexico. https://orcid.org/0000-0001-5030-8239
  • Thierry Hernández-Gilsoul Department of Continuous Institutional Care and Emergencies, Salvador Zubirán National Institute of Medical Sciences and Nutrition (INCMNSZ), Mexico City, Mexico. https://orcid.org/0000-0002-9389-9945
  • Ashuin Kammar-García Research Directorate, National Institute of Geriatrics, Mexico City, Mexico. https://orcid.org/0000-0002-3875-0945
  • Ayari Pérez Méndez Department of Continuous Institutional Care and Emergencies, Salvador Zubirán National Institute of Medical Sciences and Nutrition (INCMNSZ), Mexico City, Mexico. https://orcid.org/0000-0003-2235-2165
  • Javier Mancilla-Galindo Division of Graduate Studies, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico https://orcid.org/0000-0002-0718-467X

DOI:

https://doi.org/10.31157/an.v27i4.374

Keywords:

mortality, status epilepticus, status epilepticus severity score

Abstract

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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Published

2022-09-20

How to Cite

Vidal-Mayo, J. de J., Guzmán Ramírez, U., Hernández-Gilsoul, T., Kammar-García, A., Pérez Méndez, A., & Mancilla-Galindo, J. (2022). Evaluation of the Status Epilepticus Severity Score (STESS) as a predictor of in-hospital mortality in patients with status epilepticus: a retrospective observational study. Archivos De Neurociencias, 27(4). https://doi.org/10.31157/an.v27i4.374

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Section

Original Articles