title: Status epilepticus severity score (STESS): A useful tool to predict outcome of status epilepticus.
abstract: OBJECTIVE
  The treatment protocols for status epilepticus (SE) range from small doses of intravenous benzodiazepines to induction of coma. The pros and cons of more aggressive treatment regimen remain debatable. The importance of an index need not be overemphasized which can predict outcome of SE and guide the intensity of treatment. We tried to evaluate utility of one such index Status epilepticus severity score (STESS).
  
  
  METHODS
  44 consecutive patients of SE were enrolled in the study. STESS results were compared with various outcome measures: (a) mortality, (b) final neurological outcome at discharge as defined by functional independence measure (FIM) (good outcome: FIM score 5-7; bad outcome: FIM score 1-4), (c) control of SE within 1h of start of treatment and (d) need for coma induction.
  
  
  RESULTS
  A higher STESS score correlated significantly with poor neurological outcome at discharge (p=0.0001), need for coma induction (p=0.0001) and lack of response to treatment within 1h (p=0.001). A STESS of <3 was found to have a negative predictive value of 96.9% for mortality, 96.7% for poor neurological outcome at discharge and 96.7% for need of coma induction, while a STESS of <2 had negative predictive value of 100% for mortality, coma induction and poor neurological outcome at discharge.
  
  
  CONCLUSIONS
  STESS can reliably predict the outcome of status epilepticus. Further studies on STESS based treatment approach may help in designing better therapeutic regimens for SE.
authors.affiliation: Department of Neurology, PGIMER, Chandigarh, India.
authors.forename: Manoj Kumar
authors.initials: MK
authors.lastname: Goyal
authors.affiliation: Department of Neurology, PGIMER, Chandigarh, India.
authors.forename: Sudheer
authors.initials: S
authors.lastname: Chakravarthi
authors.affiliation: Department of Neurology, PGIMER, Chandigarh, India. Electronic address: modim72@yahoo.com.
authors.forename: Manish
authors.initials: M
authors.lastname: Modi
authors.affiliation: Department of Internal Medicine, PGIMER, Chandigarh, India.
authors.forename: Ashish
authors.initials: A
authors.lastname: Bhalla
authors.affiliation: Department of Neurology, PGIMER, Chandigarh, India.
authors.forename: Vivek
authors.initials: V
authors.lastname: Lal
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000768:Anesthesia, General / Q000379:methods*; D000927:Anticonvulsants / Q000627:therapeutic use*; D015331:Cohort Studies; D003128:Coma; D003243:Consciousness; D003661:Decision Support Techniques; D004828:Epilepsies, Partial; D004829:Epilepsy, Generalized; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods; D012720:Severity of Illness Index; D013226:Status Epilepticus / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D006993:Hypnotics and Sedatives
keywords: Clinical score; Negative predictive value; Outcome predictor; Prognostic indicator; STESS; Status epilepticus