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Evaluating the Status Epilepticus in Pediatric patients Severity Score (STEPSS): A systematic review and
Xinchi Li1, Bowen Han2, Tianhao Wu3
1Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing 210008, China; School of Foreign Languages, China Pharmaceutical University, Nanjing 211198, China.
Insights
The Status Epilepticus in Pediatric patients Severity Score (STEPSS) effectively predicts outcomes in children with status epilepticus (SE). This score enhances diagnostic accuracy for SE in pediatric patients.
Area of Science:
- Pediatric Neurology
- Critical Care Medicine
- Diagnostic Accuracy Studies
Background:
- Status epilepticus (SE) is a critical neurological emergency in children.
- The Status Epilepticus in Pediatric patients Severity Score (STEPSS) is a tool used to assess SE patient outcomes.
- Evaluating the diagnostic efficacy of STEPSS is crucial for improving pediatric SE management.
Purpose of the Study:
- To evaluate the diagnostic efficacy of the Status Epilepticus in Pediatric patients Severity Score (STEPSS) in predicting survival outcomes for pediatric SE patients.
- To synthesize existing evidence on STEPSS's predictive accuracy through meta-analysis.
Main Methods:
- A comprehensive meta-analysis of published studies was performed.
- Key performance metrics including pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were calculated.
- Heterogeneity was assessed using subgroup analysis, meta-regression, and Deek's funnel plot asymmetry test.
Main Results:
- Eight studies met the inclusion criteria for the meta-analysis.
- Pooled sensitivity and specificity for STEPSS were 0.82 and 0.78, respectively.
- The diagnostic odds ratio (DOR) was 18, and the summary receiver operating characteristic AUC (SROC-AUC) was 0.85, indicating strong diagnostic performance. Relative risk (RR) showed a 10.74-fold increase in accuracy when using STEPSS.
Conclusions:
- The STEPSS demonstrates significant predictive efficacy for pediatric SE.
- The findings support the utility of STEPSS as a valuable diagnostic tool for predicting outcomes in children with SE.
- STEPSS can aid clinicians in risk stratification and management decisions for pediatric SE.
Objective:
The Status Epilepticus in Pediatric patients Severity Score (STEPSS) has been utilized to assess outcomes in children with status epilepticus (SE). This study aims to evaluate STEPSS's diagnostic efficacy in predicting survival outcomes for SE patients.
Methods:
A meta-analysis was conducted to address this objective, calculating pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), area under the curve (AUC), Relative Risk (RR) and corresponding 95 % confidence intervals (95 % CI). Subgroup analysis, meta-regression analysis and the Deek's plot were used to evaluate heterogeneity.
Results:
Eight article met inclusion criteria. The literature exhibited non-threshold effect-caused heterogeneity. Pooled sensitivity and specificity, using a random-effects model, were 0.82 (95 % CI: 0.71, 0.90) and 0.78 (95 % CI: 0.70, 0.85), respectively. DOR was 18 (95 % CI: 8, 43), and the Summary Receiver Operating Characteristic AUC (SROC-AUC) was 0.85. Pooled RR showed that the accuracy of using STEPSS for SE diagnosis was 10.74 times higher than without using it (RR = 10.74, 95 % CI: 6.12, 18.86).
Conclusion:
STEPSS demonstrates strong predictive efficacy for pediatric SE, supporting its diagnostic use in children.
Significance:
These findings moderately validate STEPSS's utility in predicting outcomes in pediatric SE.
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