儿童癫痫持续状态严重程度评分对癫痫持续状态儿童治疗结局的预测价值

The predictive value of STEPSS on the treatment outcome of children with status epilepticus

目的 评估儿童癫痫持续状态严重程度评分(STEPSS)对癫痫持续状态(SE)儿童治疗结局的预测价值。方法 采用前瞻性研究,收集2019年5月至2021年5月在该院急诊抢救室和儿童重症监护室符合SE诊断标准的患儿,入院时记录STEPSS,随访结局包括死亡、出院时格拉斯哥预后评分(GOS)、治疗后反应。评估STEPSS在预测SE患儿不良预后方面的价值。结果 共140例SE患儿进入研究,47例预后不良,16例死亡。评价STEPSS对SE患儿不良预后预测价值的ROC曲线下面积(AUC)为0.886,95%置信区间(CI)为(0.823,0.950),P<0.001。STEPSS>3分作为截断值预测不良预后的灵敏度为0.851,特异度为0.882;预测死亡的灵敏度为0.688,特异度为0.677;预测难治性SE的灵敏度为0.778,特异度为0.685。结论 STEPSS是临床用于预测SE患儿预后和治疗反应的有效评估系统。

Objective The study aimed to evaluate the predictive value of Status Epilepticus in Pediatric patients Severity Score(STEPSS)in the treatment outcome of children with status epilepticus(SE).Methods A prospective study was conducted to collect children who met SE diagnostic criteria in the emergency rescue room and children’s intensive care unit of this hospital from May 2019 to May 2021.STEPSS score was recorded at the time of admission.Follow-up outcomes included death,Glasgow Outcome Score(GOS)at discharge and treatment response.The value of STEPSS score in predicting poor prognosis in children with SE was evaluated.Results A total of 140 children with SE were enrolled in this study,with 47 children had poor prognosis and 16 children died.The area under the ROC curve to evaluate the predictive value of STEPSS for poor prognosis in children with SE was 0.886,with 95%confidence interval(CI)was(0.823,0.950),P<0.001.STEPSS>3 scores as a cut-off value had a sensitivity of 0.851 and a specificity of 0.882 in predicting poor prognosis;a sensitivity of 0.688 and a specificity of 0.677 in predicting death;and a sensitivity of 0.778 and a specificity of 0.685 in predicting refractory SE.Conclusion STEPSS is an effective evaluation system for predicting the prognosis and response to treatment in children with SE.