External validation of STESS and EMSE as outcome prediction scores in an Egyptian cohort with status epilepticus

El-Tamawy, Mohamed S.; Amer, Hanan; Kishk, Nirmeen A.; Nawito, Amani; Basheer, Mye A.; Alieldin, Nelly; Magdy, Rehab; Othman, Alshimaa S.

doi:10.1016/j.yebeh.2019.106686

Cited by 9 publications

(13 citation statements)

References 11 publications

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“…There are clear differences between developed and developing countries in terms of the clinical characteristics of patients and healthcare facilities, and these differences may influence the SE outcome 15 . Among the current study population, 38 patients died (26.4%) due to various causes.…”

Section: Discussionmentioning

confidence: 92%

“…This might be explained by the upregulation of anti‐seizure mechanisms in patients with chronic epilepsy, in order to counteract the tendency towards seizure generation 23 . In fact, this was perfectly represented in the STESS score, 15 where the history of epilepsy was taken as a surrogate for etiology. On the other hand, acute brain insults such as anoxia, CNS infections, and acute cerebrovascular disease carry the highest weight in the EMSE score, conditions that commonly occurred in patients with no history of epilepsy 12 …”

Section: Discussionmentioning

confidence: 99%

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Characteristics and outcome in an Egyptian Cohort with status epilepticus

et al. 2021

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Objectives Status epilepticus (SE) is an important cause of mortality worldwide. Information regarding associations of mortality outcome in Egypt is limited. The main objective of this study was to describe the clinical characteristics and factors associated with mortality of patients with SE admitted to Cairo University Hospitals. Methods A prospective observational hospital‐based study was conducted from January 2017 to June 2018. Patients with SE aged ≥12 years old were followed with documentation of outcome on discharge as survival versus death. Results The study cohort included 144 SE patients. The majority of episodes (96.5%) were with prominent motor features, while nonconvulsive SE occurred in 3.5%. There was a clear semiology evolution in 22.9% of episodes, 56.3% had unchanging semiology (e.g., just convulsive or just nonconvulsive) and the semiology evolution could not be discerned in 20.8%. In relation to treatment, the majority of cases were responsive (46.5%), whereas 43.1% were refractory and only 10.4% were super‐refractory SE. Apart from seven patients who were referred to other hospitals, 99 patients survived whereas 38 (26.4%) died. After regression analysis, only absence of a history of epilepsy, semiology evolution and mechanical ventilator use were associated with mortality increasing its odds by 3.7, 5, 111 times, respectively. Conclusion Absence of a history of epilepsy, SE semiology evolution, and mechanical ventilator use was found to be associated with mortality outcome among Egyptian patients with SE.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Characteristics and outcome in an Egyptian Cohort with status epilepticus

et al. 2021

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“…The median days of hospitalisation were 8 [5][6][7][8][9][10][11][12][13][14][15][16][17][18], with a median of 4 [1][2][3][4][5][6][7][8][9] days in the ICU. Sixty-six patients (16.8 %) died in the hospital, 54.5 % died after a complication related to the SE, and 45.5 % died due to an illness different from SE; multiple organ failure (19.7 %) and sepsis (16.7 %) constitute the leading causes of total deaths.…”

Section: Resultsmentioning

confidence: 99%

“…Predicting outcome in SE is a challenge. Several studies in different regions of the world have shown that STESS could contribute to predicting the outcome by using different cutoff points [15][16][17][18]22]. The score must be analysed according to different demographic characteristics to improve the therapeutic strategies.…”

Section: Discussionmentioning

confidence: 99%

“…With a maximum score of 6, older age (>65 years), absence of epilepsy history, extent of consciousness impairment (stupor and coma), and presence of generalised convulsive seizures or nonconvulsive status epilepticus (NCSE) in a coma at onset are significantly associated with higher odds for death [11]. Furthermore, STESS has proven its usefulness in predicting mortality among patients with SE worldwide [14][15][16][17][18]. Our study purpose was to validate STESS in Medellin, Colombia.…”

Section: Introductionmentioning

confidence: 99%

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Validation of the Status epilepticus severity score (STESS) at high-complexity hospitals in Medellín, Colombia

Sandoval

Rio

Gómez

et al. 2020

Seizure

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The Status Epilepticus Severity Score (STESS) is one of the most well-known clinical scoring systems to predict mortality in status epilepticus (SE). The objective of this study was to validate STESS in a Colombian population. Method: We evaluated historical data of adult patients (age ≥16 years) with a clinical or electroencephalographic diagnosis of SE admitted between 2014 and 2017. Prospectively, we included patients admitted from January to June of 2018. The primary outcome was in-hospital mortality. Receiver operating characteristic (ROC)-analysis, determination of best cutoff values, sensitivity, specificity, and positive and negative likelihood ratios were performed. Results: The sample was 395 patients, with in-hospital mortality of 16.8 %. The area under the ROC curve for STESS was 0.84. A cutoff point of ≥3 produced the highest sensitivity of 84.9 % (95 % CI 73.9 %-92.5 %) and a specificity of 65.7 % (95 % CI 60.2 %-70.8 %), with a positive likelihood ratio of 2.5 and a negative likelihood ratio of 0.2. Conclusions: STESS is a useful tool to predict mortality in patients with SE. In Medellin, Colombia, a STESS < 3 allows the identification of the patients who survive reliably. Those patients with a score <3 may have a better prognosis, and treatment with fewer side effects than anaesthetics could be suggested, always remembering the importance of the treating physician's clinical judgement.

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RETRACTED: Outcome of neurocritical disorders, a multicenter prospective cross‐sectional study

Ali

Salih

AbuGabal³

et al. 2022

Brain and Behavior

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Background: Patients with neurocritical disorders who require admission to intensive care units (ICUs) constitute about 10-15% of critical care cases. Objectives:To study the outcome of neurocritical disorders in intensive care units.Methodology: This is a prospective cross-sectional study that was conducted among neurocritical patients who were admitted in four intensive care units of four major hospitals in Khartoum state during the period from November 2020 to March 2021.Results: Seventy-two neurocritical patients were included in this study; 40(55.6%) were males and 32(44.4%) were females. Twenty-one (29.2%) patients fully recovered, 35 (48.6%) partially recovered and 16 (22.2%) died. The mortality of the common neurocritical diseases were as follows: stroke 30.4%, encephalitis (8.3%), status epilepticus (11.1%), Guillain-Barre syndrome (GBS) (16.7%), and myasthenia gravis (MG) (25%). Conclusion:This study identified that near two-thirds of the patients required mechanical ventilation. Delayed admission was observed due to causes distributed between the medical side and patient side. The majority of patients were discharged from ICU with partial recovery.

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External validation of STESS and EMSE as outcome prediction scores in an Egyptian cohort with status epilepticus

Cited by 9 publications

References 11 publications

Characteristics and outcome in an Egyptian Cohort with status epilepticus

Characteristics and outcome in an Egyptian Cohort with status epilepticus

Validation of the Status epilepticus severity score (STESS) at high-complexity hospitals in Medellín, Colombia

RETRACTED: Outcome of neurocritical disorders, a multicenter prospective cross‐sectional study

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