儿童癫痫持续状态严重程度评分量表与PEDSS评分量表对癫痫持续状态患儿近期预后评估的应用价值

Application value of the Status Epilepticus in Pediatric Severity Score and PEDSS in assessing the short-term prognosis of children with status epilepticus

目的验证并比较儿童癫痫持续状态严重程度评分量表(STEPSS)与PEDSS评分量表对癫痫持续状态(SE)患儿近期预后评估的应用价值。方法回顾性分析2020年1月至2022年12月在郑州大学第一附属医院住院治疗的152例SE患儿的临床资料。根据STEPSS与PEDSS评分量表对患儿进行评分并预测患儿预后, 通过绘制2个量表各自的受试者工作特征(ROC)曲线, 计算曲线下面积(AUC), 找出理想界值, 计算界值对应的敏感度、特异度, 以此来验证并比较STEPSS与PEDSS评分量表对SE患儿预后评估的应用价值。结果 152例SE患儿中, 男90例, 女62例;年龄1个月至15岁[(5.8±3.9)岁]。预后良好112例, 预后不良40例, 其中死亡13例。在预测死亡方面, STEPSS与PEDSS评分量表的AUC分别为0.908(95%CI:0.848~0.967)、0.887(95%CI:0.831~0.942), 理想界值均为4, 敏感度分别为0.740、0.846, 特异度分别为0.745、0.835。2个评分量表比较差异无统计学意义(P>0.05)。在预测不良结局方面, STEPSS与PEDSS评分量表的AUC分别为0.869(95%CI:0.800~0.937)、0.926(95%CI:0.873~0.979), 理想界值均为3, 敏感度分别为0.827、0.900, 特异度分别为0.732、0.866, 2个评分量表比较差异有统计学意义(P<0.05)。结论与STEPSS评分量表相比, PEDSS评分量表预测SE患儿的近期治疗结局具有更高的应用价值, 可作为评估SE患儿预后的常规方法。

Objective To validate and compare the value of the Status Epilepticus in Pediatric Severity Score(STEPSS)versus PEDSS in assessing the short-term prognosis of children with status epilepticus(SE).Methods Clinical data of 152 children with SE hospitalized at the First Affiliated Hospital of Zhengzhou University from January 2020 to December 2022 were retrospectively analyzed.According to the STEPSS and PEDSS scores,children with SE were scored and their prognosis was predicted.Receiver operating characteristic(ROC)curves of the 2 scales in assessing the short-term prognosis of SE in children were plotted,and the area under the curve(AUC),optimal cut-off,sensitivity and specificity were calculated,thus validating and comparing the value of the STEPSS versus PEDSS in assessing the short-term prognosis of children with SE.Results Of the 152 children with SE,90 were male and 62 were female,with the age of(5.8±3.9)years(1 month to 15 years).There were 112 cases with good prognosis and 40 cases with poor prognosis,involving 13 deaths.The AUC of STEPSS and PEDSS scores in predicting the death in children with SE were 0.908(95%CI:0.848-0.967)and 0.887(95%CI:0.831-0.942),respectively,both with the optimal cut-off value of 4.The sensitivity of STEPSS and PEDSS scores in predicting the death in children with SE were 0.740 and 0.846,respectively,and the specificity were 0.745 and 0.835,respectively.There was no significant difference in predicting the death in children with SE between the 2 scales(P>0.05).In predicting adverse outcomes,the AUC of the STEPSS and PEDSS scores were 0.869(95%CI:0.800-0.937)and 0.926(95%CI:0.873-0.979),respectively,both with the optimal cut-off value of 3.The sensitivity of STEPSS and PEDSS scores in predicting adverse outcomes in children with SE were 0.827 and 0.900,respectively,and the specificity were 0.732 and 0.866,respectively.There was significant difference in predicting the adverse outcomes in children with SE between the 2 scales(P<0.05).Conclusions Compared with the STEPSS,the PEDSS has a higher application in predicting the short-term treatment outcome of children with SE,which can be used as a routine method to assess the prognosis of children with SE.