Validation of the Status epilepticus severity score (STESS) at high-complexity hospitals in Medellín, Colombia
•STESS is a valuable tool to predict mortality in patients with status epilepticus.•A cutoff point ≥3 discriminates well survivors and nonsurvivors in Medellin.•STESS-3 is better to justify treatment with fewer side effects than anaesthetics. The Status Epilepticus Severity Score (STESS) is one of t...
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| Veröffentlicht in: | Seizure (London, England) England), 2020-10, Vol.81, p.287-291 |
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| creator | Millán Sandoval, Juan Pablo Escobar del Rio, Luisa María Gómez, Edison Augusto Ladino, Lady Diana Ospina, Lina María López Díaz, Diana Marcela Zapata, José Fernando Hernández, Olga Helena |
| description | •STESS is a valuable tool to predict mortality in patients with status epilepticus.•A cutoff point ≥3 discriminates well survivors and nonsurvivors in Medellin.•STESS-3 is better to justify treatment with fewer side effects than anaesthetics.
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.
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.
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.
STESS is a useful tool to predict mortality in patients with SE. In Medellin, Colombia, a STESS |
| doi_str_mv | 10.1016/j.seizure.2020.08.020 |
| format | Article |
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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.
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.
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.
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.</description><identifier>ISSN: 1059-1311</identifier><identifier>EISSN: 1532-2688</identifier><identifier>DOI: 10.1016/j.seizure.2020.08.020</identifier><language>eng</language><publisher>Elsevier Ltd</publisher><subject>Complication ; Death ; Epilepsy ; Outcome ; Prognosis ; Score</subject><ispartof>Seizure (London, England), 2020-10, Vol.81, p.287-291</ispartof><rights>2020 British Epilepsy Association</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c389t-d31348619708b9e65d73084a475ba6a2a98ff418dc5b073f7a0b2280c637e63c3</citedby><cites>FETCH-LOGICAL-c389t-d31348619708b9e65d73084a475ba6a2a98ff418dc5b073f7a0b2280c637e63c3</cites><orcidid>0000-0001-8816-1930 ; 0000-0002-4841-2704 ; 0000-0001-5656-2908 ; 0000-0002-9738-0489 ; 0000-0002-3493-2872</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1059131120302570$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids></links><search><creatorcontrib>Millán Sandoval, Juan Pablo</creatorcontrib><creatorcontrib>Escobar del Rio, Luisa María</creatorcontrib><creatorcontrib>Gómez, Edison Augusto</creatorcontrib><creatorcontrib>Ladino, Lady Diana</creatorcontrib><creatorcontrib>Ospina, Lina María López</creatorcontrib><creatorcontrib>Díaz, Diana Marcela</creatorcontrib><creatorcontrib>Zapata, José Fernando</creatorcontrib><creatorcontrib>Hernández, Olga Helena</creatorcontrib><title>Validation of the Status epilepticus severity score (STESS) at high-complexity hospitals in Medellín, Colombia</title><title>Seizure (London, England)</title><description>•STESS is a valuable tool to predict mortality in patients with status epilepticus.•A cutoff point ≥3 discriminates well survivors and nonsurvivors in Medellin.•STESS-3 is better to justify treatment with fewer side effects than anaesthetics.
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.
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.
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.
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.</description><subject>Complication</subject><subject>Death</subject><subject>Epilepsy</subject><subject>Outcome</subject><subject>Prognosis</subject><subject>Score</subject><issn>1059-1311</issn><issn>1532-2688</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNqFUM1KxDAYLKKgrj6CkKOCrflrm55ElvUHFA-7eg1p-tXN0m1qki7qO_kUvphZ1runGfhmhm8mSc4IzggmxdUq82C-RgcZxRRnWGQR9pIjkjOa0kKI_chxXqWEEXKYHHu_whhXnLCjxL6qzjQqGNsj26KwBDQPKowewWA6GILRkXvYgDPhE3ltHaDz-WI2n18gFdDSvC1TbddDBx9bwdL6wQTVeWR69AQNdN3Pd3-Jpraz69qok-SgjVc4_cNJ8nI7W0zv08fnu4fpzWOqmahC2jDCuChIVWJRV1DkTcmw4IqXea0KRVUl2pYT0ei8xiVrS4VrSgXWBSuhYJpNkvNd7uDs-wg-yLXxOn6jerCjl5RzKnjOCh6l-U6qnfXeQSsHZ9bKfUqC5XZguZJ_A8vtwBILGSH6rnc-iD02Bpz02kCvoTEOdJCNNf8k_AJQ_Ygp</recordid><startdate>202010</startdate><enddate>202010</enddate><creator>Millán Sandoval, Juan Pablo</creator><creator>Escobar del Rio, Luisa María</creator><creator>Gómez, Edison Augusto</creator><creator>Ladino, Lady Diana</creator><creator>Ospina, Lina María López</creator><creator>Díaz, Diana Marcela</creator><creator>Zapata, José Fernando</creator><creator>Hernández, Olga Helena</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8816-1930</orcidid><orcidid>https://orcid.org/0000-0002-4841-2704</orcidid><orcidid>https://orcid.org/0000-0001-5656-2908</orcidid><orcidid>https://orcid.org/0000-0002-9738-0489</orcidid><orcidid>https://orcid.org/0000-0002-3493-2872</orcidid></search><sort><creationdate>202010</creationdate><title>Validation of the Status epilepticus severity score (STESS) at high-complexity hospitals in Medellín, Colombia</title><author>Millán Sandoval, Juan Pablo ; Escobar del Rio, Luisa María ; Gómez, Edison Augusto ; Ladino, Lady Diana ; Ospina, Lina María López ; Díaz, Diana Marcela ; Zapata, José Fernando ; Hernández, Olga Helena</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c389t-d31348619708b9e65d73084a475ba6a2a98ff418dc5b073f7a0b2280c637e63c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Complication</topic><topic>Death</topic><topic>Epilepsy</topic><topic>Outcome</topic><topic>Prognosis</topic><topic>Score</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Millán Sandoval, Juan Pablo</creatorcontrib><creatorcontrib>Escobar del Rio, Luisa María</creatorcontrib><creatorcontrib>Gómez, Edison Augusto</creatorcontrib><creatorcontrib>Ladino, Lady Diana</creatorcontrib><creatorcontrib>Ospina, Lina María López</creatorcontrib><creatorcontrib>Díaz, Diana Marcela</creatorcontrib><creatorcontrib>Zapata, José Fernando</creatorcontrib><creatorcontrib>Hernández, Olga Helena</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Seizure (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Millán Sandoval, Juan Pablo</au><au>Escobar del Rio, Luisa María</au><au>Gómez, Edison Augusto</au><au>Ladino, Lady Diana</au><au>Ospina, Lina María López</au><au>Díaz, Diana Marcela</au><au>Zapata, José Fernando</au><au>Hernández, Olga Helena</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Validation of the Status epilepticus severity score (STESS) at high-complexity hospitals in Medellín, Colombia</atitle><jtitle>Seizure (London, England)</jtitle><date>2020-10</date><risdate>2020</risdate><volume>81</volume><spage>287</spage><epage>291</epage><pages>287-291</pages><issn>1059-1311</issn><eissn>1532-2688</eissn><abstract>•STESS is a valuable tool to predict mortality in patients with status epilepticus.•A cutoff point ≥3 discriminates well survivors and nonsurvivors in Medellin.•STESS-3 is better to justify treatment with fewer side effects than anaesthetics.
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.
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.
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.
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.</abstract><pub>Elsevier Ltd</pub><doi>10.1016/j.seizure.2020.08.020</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0001-8816-1930</orcidid><orcidid>https://orcid.org/0000-0002-4841-2704</orcidid><orcidid>https://orcid.org/0000-0001-5656-2908</orcidid><orcidid>https://orcid.org/0000-0002-9738-0489</orcidid><orcidid>https://orcid.org/0000-0002-3493-2872</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Complication Death Epilepsy Outcome Prognosis Score |
| title | Validation of the Status epilepticus severity score (STESS) at high-complexity hospitals in Medellín, Colombia |
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