Utility of the END-IT Score to Predict the outcome of Childhood Status Epilepticus: A Retrospective Cohort Study

Area of Science:

• Pediatric Neurology
• Critical Care Medicine
• Clinical Outcomes Research

Background:

• Pediatric status epilepticus (SE) lacks robust outcome prediction tools.
• Existing scoring systems for pediatric SE are limited in their predictive capabilities.
• The END-IT score's utility in pediatric SE requires further investigation.

Purpose of the Study:

• To assess the usefulness of the END-IT score in predicting outcomes for pediatric status epilepticus (SE).
• To evaluate the END-IT score's accuracy in forecasting short-term outcomes and SE progression.
• To establish the predictive value of the END-IT score in a pediatric SE cohort.

Main Methods:

• Retrospective study conducted at a tertiary hospital in New Delhi, India.
• Enrolled 140 children (1 month-18 years) with seizures lasting ≥5 minutes or active convulsions.
• Correlated END-IT scores with Pediatric Overall Performance Category (POPC) scale, mortality, and progression to refractory SE (RSE) and super-refractory SE (SRSE).

Main Results:

• The END-IT score demonstrated high specificity and NPV for predicting unfavorable outcomes and death.
• At a cutoff > 2, the END-IT score showed a sensitivity of 0.73 for unfavorable outcomes and 0.86 for death.
• The score also showed predictive value for progression to RSE (sensitivity 0.80) and SRSE (sensitivity 0.67).

Conclusions:

• The END-IT score is a useful tool for predicting short-term outcomes in pediatric SE.
• This study demonstrates the END-IT score's utility in predicting progression to refractory and super-refractory SE in children.
• The findings support the use of the END-IT score for improved management of pediatric SE.