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Utility of the END-IT score to predict the outcome of childhood status epilepticus: A retrospective cohort study
Annals of Indian Academy of Neurology ( IF 1.7 ) Pub Date : 2021-05-01 , DOI: 10.4103/aian.aian_1319_20 Dipti Kapoor 1 , Sidharth 1 , Divyani Garg 2 , Rajiv K Malhotra 3 , Virendra Kumar 1 , Suvasini Sharma 1
Introduction: Scoring systems to predict outcomes in pediatric status epilepticus (SE) are limited. We sought to assess usefulness of the END-IT score in pediatric SE. Methodology: We conducted a retrospective study at a tertiary hospital in New Delhi, India. Children aged 1 month–18 years who presented with seizure for ≥5 min/actively convulsing to emergency were enrolled. END-IT score was calculated and correlated with outcome at discharge using Pediatric Overall Performance Category (POPC) scale, in-hospital mortality, and progression to refractory and super-refractory SE (SRSE). Results: We enrolled 140 children (mean age 5.8 years; 67.1% males). Seven children died and 15 had unfavorable outcomes. The predictive accuracy of END-IT at a cutoff of > 2: for unfavorable outcome (POPC score ≥3) was: sensitivity 0.73 (95% CI: 0.45–0.92), specificity 0.94 (95% CI: 0.89–0.98), PPV 0.61 (95% CI: 0.36–0.83), NPV 0.97 (95% CI: 0.92–0.99), positive likelihood ratio (13.09), F1 score (0.666); for death: sensitivity 0.86 (95% CI: 0.42–0.99), specificity 0.91 (95% CI: 0.85–0.95), PPV 0.33 (95% CI: 0.13–0.59), NPV 0.99 (95% CI: 0.96–1.00), F1 score (0.48); for RSE: sensitivity 0.80 (95%CI: 0.28–0.99), specificity 0.90 (95% CI: 0.83–0.94), PPV 0.22 (95% CI: 0.06–0.48) NPV 0.99 (95% CI: 0.96–1.00), F1 score (0.35); for SRSE: sensitivity 0.67 (95% CI: 0.22–0.96) specificity 0.75 (95% CI: 0.66–0.82), PPV 0.22 (95% CI: 0.06–0.48) NPV 0.98 (95% CI: 0.94–0.99), F1 score (0.33). Conclusion: We demonstrate utility of the END-IT score to predict short-term outcomes as well as progression to refractory and SRSE for the first time among children with SE.
中文翻译：
END-IT评分预测儿童癫痫持续状态结果的效用：一项回顾性队列研究
简介：预测小儿癫痫持续状态 (SE) 结局的评分系统是有限的。我们试图评估 END-IT 评分在儿科 SE 中的有用性。方法：我们在印度新德里的一家三级医院进行了一项回顾性研究。入组 1 个月至 18 岁癫痫发作 ≥5 分钟/主动抽搐至急诊的儿童。使用儿科总体表现类别 (POPC) 量表计算 END-IT 评分并将其与出院时的结果、住院死亡率以及进展为难治性和超难治性 SE (SRSE) 相关联。结果：我们招募了 140 名儿童（平均年龄 5.8 岁；67.1% 为男性）。7 名儿童死亡，15 名儿童出现不良后果。END-IT 在 > 2 的临界值下的预测准确性：对于不利结果（POPC 评分≥3）为：敏感性 0.73（95% CI：0.45-0.92），特异性 0.94（95% CI：0.89-0.98），PPV 0.61（95% CI：0.36-0.83），NPV 0.97（95% CI：0.92-0.99），阳性似然比（13.09），F1评分（0.666）；死亡：敏感性 0.86 (95% CI: 0.42–0.99), 特异性 0.91 (95% CI: 0.85–0.95), PPV 0.33 (95% CI: 0.13–0.59), NPV 0.99 (95% CI: 0.96–1.00) , F1 分数 (0.48); 对于 RSE：敏感性 0.80 (95% CI: 0.28–0.99)，特异性 0.90 (95% CI: 0.83–0.94), PPV 0.22 (95% CI: 0.06–0.48) NPV 0.99 (95% CI: 0.96–1.00), F1分数（0.35）；对于 SRSE：敏感性 0.67 (95% CI: 0.22–0.96) 特异性 0.75 (95% CI: 0.66–0.82), PPV 0.22 (95% CI: 0.06–0.48) NPV 0.98 (95% CI:结论：我们首次证明了 END-IT 评分可用于预测 SE 儿童的短期结果以及进展为难治性和 SRSE。
更新日期：2021-05-01
Annals of Indian Academy of Neurology ( IF 1.7 ) Pub Date : 2021-05-01 , DOI: 10.4103/aian.aian_1319_20 Dipti Kapoor 1 , Sidharth 1 , Divyani Garg 2 , Rajiv K Malhotra 3 , Virendra Kumar 1 , Suvasini Sharma 1
Affiliation
Introduction: Scoring systems to predict outcomes in pediatric status epilepticus (SE) are limited. We sought to assess usefulness of the END-IT score in pediatric SE. Methodology: We conducted a retrospective study at a tertiary hospital in New Delhi, India. Children aged 1 month–18 years who presented with seizure for ≥5 min/actively convulsing to emergency were enrolled. END-IT score was calculated and correlated with outcome at discharge using Pediatric Overall Performance Category (POPC) scale, in-hospital mortality, and progression to refractory and super-refractory SE (SRSE). Results: We enrolled 140 children (mean age 5.8 years; 67.1% males). Seven children died and 15 had unfavorable outcomes. The predictive accuracy of END-IT at a cutoff of > 2: for unfavorable outcome (POPC score ≥3) was: sensitivity 0.73 (95% CI: 0.45–0.92), specificity 0.94 (95% CI: 0.89–0.98), PPV 0.61 (95% CI: 0.36–0.83), NPV 0.97 (95% CI: 0.92–0.99), positive likelihood ratio (13.09), F1 score (0.666); for death: sensitivity 0.86 (95% CI: 0.42–0.99), specificity 0.91 (95% CI: 0.85–0.95), PPV 0.33 (95% CI: 0.13–0.59), NPV 0.99 (95% CI: 0.96–1.00), F1 score (0.48); for RSE: sensitivity 0.80 (95%CI: 0.28–0.99), specificity 0.90 (95% CI: 0.83–0.94), PPV 0.22 (95% CI: 0.06–0.48) NPV 0.99 (95% CI: 0.96–1.00), F1 score (0.35); for SRSE: sensitivity 0.67 (95% CI: 0.22–0.96) specificity 0.75 (95% CI: 0.66–0.82), PPV 0.22 (95% CI: 0.06–0.48) NPV 0.98 (95% CI: 0.94–0.99), F1 score (0.33). Conclusion: We demonstrate utility of the END-IT score to predict short-term outcomes as well as progression to refractory and SRSE for the first time among children with SE.
中文翻译：
END-IT评分预测儿童癫痫持续状态结果的效用：一项回顾性队列研究
简介：预测小儿癫痫持续状态 (SE) 结局的评分系统是有限的。我们试图评估 END-IT 评分在儿科 SE 中的有用性。方法：我们在印度新德里的一家三级医院进行了一项回顾性研究。入组 1 个月至 18 岁癫痫发作 ≥5 分钟/主动抽搐至急诊的儿童。使用儿科总体表现类别 (POPC) 量表计算 END-IT 评分并将其与出院时的结果、住院死亡率以及进展为难治性和超难治性 SE (SRSE) 相关联。结果：我们招募了 140 名儿童（平均年龄 5.8 岁；67.1% 为男性）。7 名儿童死亡，15 名儿童出现不良后果。END-IT 在 > 2 的临界值下的预测准确性：对于不利结果（POPC 评分≥3）为：敏感性 0.73（95% CI：0.45-0.92），特异性 0.94（95% CI：0.89-0.98），PPV 0.61（95% CI：0.36-0.83），NPV 0.97（95% CI：0.92-0.99），阳性似然比（13.09），F1评分（0.666）；死亡：敏感性 0.86 (95% CI: 0.42–0.99), 特异性 0.91 (95% CI: 0.85–0.95), PPV 0.33 (95% CI: 0.13–0.59), NPV 0.99 (95% CI: 0.96–1.00) , F1 分数 (0.48); 对于 RSE：敏感性 0.80 (95% CI: 0.28–0.99)，特异性 0.90 (95% CI: 0.83–0.94), PPV 0.22 (95% CI: 0.06–0.48) NPV 0.99 (95% CI: 0.96–1.00), F1分数（0.35）；对于 SRSE：敏感性 0.67 (95% CI: 0.22–0.96) 特异性 0.75 (95% CI: 0.66–0.82), PPV 0.22 (95% CI: 0.06–0.48) NPV 0.98 (95% CI:结论：我们首次证明了 END-IT 评分可用于预测 SE 儿童的短期结果以及进展为难治性和 SRSE。
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