title: Prediction of functional outcome in patients with convulsive status epilepticus: the END-IT score.
abstract: BACKGROUND
  Prediction of the functional outcome for patients with convulsive status epilepticus (CSE) has been a challenge. The aim of this study was to characterize the prognostic factors and functional outcomes of patients after CSE in order to develop a practicable scoring system for outcome prediction.
  
  
  METHODS
  We performed a retrospective explorative analysis on consecutive patients diagnosed with CSE between March, 2008 and November, 2014 in a tertiary academic medical center in northwest China. The modified Rankin Scale (mRS) was used to measure the functional outcome at three months post discharge.
  
  
  RESULTS
  A total of 132 CSE patients was included, with a median age of 25.5 years and 60.6% were male. Three months post discharge, an unfavorable outcome with mRS of 3-6 was seen in 62 (47.0%) patients, 25 (18.9%) of whom died. Logistic regression analysis revealed that encephalitis (p = 0.029), nonconvulsive SE (p = 0.018), diazepam resistance (p = 0.005), image abnormalities (unilateral lesions, p = 0.027; bilateral lesions or diffuse cerebral edema, p < 0.001) and tracheal intubation (p = 0.032) were significant independent predictors for unfavorable outcomes. Based on the coefficients in the model, these predictors were assigned a value of 1 point each, with the exception of the image, creating a 6-point scoring system, which we refer to as END-IT, for the outcome prediction of CSE. The area under the receiver operating characteristic curve for the END-IT score was 0.833 and using a cut-off point of 3 produced the highest sum sensitivity (83.9%) and specificity (68.6%). Compared with status epilepticus severity score (STESS) and Epidemiology-based Mortality score in SE (EMSE), END-IT score showed better discriminative power and predictive accuracy for the outcome prediction.
  
  
  CONCLUSIONS
  We developed an END-IT score with a strong discriminative power for predicting the functional outcome of CSE patients. External prospective validation in different cohorts is needed for END-IT score.
authors.affiliation: Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, PR China. gaoqq0513@163.com.
authors.forename: Qiong
authors.initials: Q
authors.lastname: Gao
authors.affiliation: Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, PR China. oytp2008@126.com.
authors.forename: Tang-peng
authors.initials: TP
authors.lastname: Ou-Yang
authors.affiliation: Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, PR China. fmmulong@foxmail.com.
authors.forename: Xiao-long
authors.initials: XL
authors.lastname: Sun
authors.affiliation: Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, PR China. arthuryf@163.com.
authors.forename: Feng
authors.initials: F
authors.lastname: Yang
authors.affiliation: Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, PR China. wuchen149@126.com.
authors.forename: Chen
authors.initials: C
authors.lastname: Wu
authors.affiliation: Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, PR China. kangtao1995@163.com.
authors.forename: Tao
authors.initials: T
authors.lastname: Kang
authors.affiliation: Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, PR China. paraq@163.com.
authors.forename: Xiao-gang
authors.initials: XG
authors.lastname: Kang
authors.affiliation: Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, PR China. jiangwen@fmmu.edu.cn.
authors.forename: Wen
authors.initials: W
authors.lastname: Jiang
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China; D005260:Female; D005544:Forecasting / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013226:Status Epilepticus / Q000401:mortality*; D016019:Survival Analysis; D016896:Treatment Outcome