Abstracts

Rationale: Status epilepticus (SE) is a neurological emergency and with disabling neurological deficits. It becomes important to have a simple and reliable tool to predict the risk of death at SE onset. There are 2 clinical scoring systems to predict outcome: “The Status Epilepticus Severity Score (STESS)”, which has been previously validated, and “The Epidemiology- based Mortality score in SE (EMSE)”. In addition, it results necessary a scoring system that could orientate treatment strategy. Objetive: outcome evaluation in patients with SE using two scoring systems: STESS and EMSE.Methods: A retrospective review of clinical and electroencephalographic (EEG) data for all adult patients with SE from January 2009 to December 2014. SE was defined as a clinical and EEG evidence of seizure activity that lasted at least 5 minutes or as a series of epileptic seizures that had to be present without complete clinical recovery in between. EEG was revised by two electroencephalographists, EEG-criteria for NCSE was defined by Beniczky and colleagues (2013). STESS used: level of consciousness, ‘‘worst'' seizure type, age and history of previous seizures. A score of three points or higher indicates bad outcome. EMSE used: aetiology, age, comorbidity, EEG, duration and level of consciousness. EMSE-EAC (aetiology- age-comorbidity) with cut-off 27 or higher and EMSE-EACE (aetiology- age-comorbidity-EEG) with cut-off 64 or higher indicates poor outcome respectively. To analyse data, we used GraphPad-prism 5 software and Mann-Whitney test. P <0.05 was used as significant.Results: We have included 46 patients (32 females) with an average of age 70.9 ± 2.2 years old (range 16-99). Our data have shown 28% of mortality with an average of 80.7 years old. The most common etiologies were systemic infection (23.9%), stroke (19.5%) and cryptogenic (17.3%). The prevalence of potentially fatal etiology (PFE) and acute symptomatic seizures (ASS) were 28 patients and 35 patients respectively. The mortality in ASS was 31.4 % (11/35) while in the group of PFE was 35.7% (10/28). Our findings have shown that STESS could be better mortality predictor than EMSE. Risk ratio was 3 and p= 0.017; while EMSE-EAC and EMSE-EACE were 2.9 with p=0.2 in both questionnaires. Moreover, we found statistically significant differences in STESS score average between non-survival and survival patients (2.8 ± 0.2 vs 4.6 ± 0.4; p < 0.001). Nevertheless, EMSE-EAC neither EMSE-EACE have not shown differences between both groups. Additionally, using a 4 as cut off for STESS we found 61.5% of sensitivity (Se) and 75.7 of specificity (Sp); while EMSE-EAC showed Se of 92.3% with low Sp of 24.2% and EMSE-EACE got Se of 100% but with a Sp of 3%.Conclusions: In our series of 46 patients we have found significant differences in STESS score between non-survival and survival patients with a cut off of 4 or more points.However, when using the EMSE score we have not found statistical dissimilarities.This could possibly be because we have a different aetiology and comorbidity pattern and as a result of the fact that our average age is older than the population evaluated.