PMID- 37965804
OWN - NLM
STAT- MEDLINE
DCOM- 20240115
LR  - 20240115
IS  - 1528-1167 (Electronic)
IS  - 0013-9580 (Linking)
VI  - 65
IP  - 1
DP  - 2024 Jan
TI  - Prognostic value of Salzburg nonconvulsive status epilepticus criteria: The SACE 
      score.
PG  - 138-147
LID - 10.1111/epi.17830 [doi]
AB  - OBJECTIVE: This study was undertaken to investigate the association between the 
      Salzburg nonconvulsive status epilepticus (NCSE) criteria and in-hospital 
      outcome, to determine the predictive accuracy of the Status Epilepticus Severity 
      Score (STESS), modified STESS (mSTESS), Epidemiology-Based Mortality Score in 
      Status Epilepticus (EMSE), and END-IT (encephalitis, NCSE, diazepam resistance, 
      imaging features, and tracheal intubation) in NCSE patients, and to develop a new 
      prognostic score specifically designed for NCSE patients. METHODS: Clinical and 
      electroencephalographic (EEG) data of adult patients treated for NCSE from 2020 
      to 2023 were retrospectively assessed. Age, sex, modified Rankin Scale at 
      admission, comorbidities, history of seizures, etiology, status epilepticus type, 
      and outcome were collected from the patients' digital charts. EEG data were 
      assessed and categorized applying the Salzburg NCSE criteria. In-hospital death 
      was defined as the primary outcome. RESULTS: A total of 116 NCSE patients were 
      included. Multivariable logistic regression revealed that Salzburg NCSE criterion 
      A2 (ictal morphological, spatial, and temporal evolution) was associated with 
      in-hospital survival. The best STESS cutoff was >/=4 (sensitivity = .62, 
      specificity = .69, accuracy = 67%). mSTESS >/= 5 reached a sensitivity of .68, a 
      specificity of .57, and an overall accuracy of 60%, EMSE >/= 64 a sensitivity of 
      .82, a specificity of .39, and an overall accuracy of 52%, and END-IT >/= 3 a 
      sensitivity of .65, a specificity of .44, and an overall accuracy of 50%. Through 
      a hypothesis-generating approach, we developed the SACE score, which integrates 
      EEG features (criterion A2) with patient age (with a 75-year cutoff), history of 
      seizures, and level of consciousness. With a cutoff of >/=3, it had a sensitivity 
      of .77, a specificity of .74, and an overall accuracy of 76%, performing better 
      than other prognostic scores. SIGNIFICANCE: We developed a new user-friendly 
      scoring system, the SACE score, which integrates EEG features with other 
      established outcome-related variables assessable in early stages, to assist 
      neurologists and neurointensivists in making more tailored prognostic decisions 
      for NCSE patients.
CI  - (c) 2023 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of 
      International League Against Epilepsy.
FAU - Misirocchi, Francesco
AU  - Misirocchi F
AUID- ORCID: 0000-0001-8730-4397
AD  - Unit of Neurology, Department of Medicine and Surgery, University of Parma, 
      Parma, Italy.
FAU - Zilioli, Alessandro
AU  - Zilioli A
AD  - Unit of Neurology, Department of Medicine and Surgery, University of Parma, 
      Parma, Italy.
FAU - Mannini, Elisa
AU  - Mannini E
AD  - Unit of Neurology, Department of Medicine and Surgery, University of Parma, 
      Parma, Italy.
FAU - Lazzari, Stefania
AU  - Lazzari S
AD  - Unit of Neurology, Department of Medicine and Surgery, University of Parma, 
      Parma, Italy.
FAU - Mutti, Carlotta
AU  - Mutti C
AD  - Unit of Neurology, University Hospital of Parma, Parma, Italy.
AD  - Sleep Disorders Center, Department of Medicine and Surgery, University of Parma, 
      Parma, Italy.
FAU - Zinno, Lucia
AU  - Zinno L
AD  - Unit of Neurology, University Hospital of Parma, Parma, Italy.
FAU - Parrino, Liborio
AU  - Parrino L
AD  - Unit of Neurology, Department of Medicine and Surgery, University of Parma, 
      Parma, Italy.
AD  - Sleep Disorders Center, Department of Medicine and Surgery, University of Parma, 
      Parma, Italy.
FAU - De Stefano, Pia
AU  - De Stefano P
AUID- ORCID: 0000-0002-7979-0994
AD  - EEG and Epilepsy Unit, Department of Clinical Neurosciences, University Hospital 
      of Geneva, Geneva, Switzerland.
AD  - Neuro-Intensive Care Unit, Department of Intensive Care, University Hospital of 
      Geneva, Geneva, Switzerland.
FAU - Florindo, Irene
AU  - Florindo I
AD  - Unit of Neurology, University Hospital of Parma, Parma, Italy.
LA  - eng
GR  - 2023 International Federation of Clinical Neurophysiology Research Fellowship/
GR  - 2022 Swiss League Against Epilepsy Research Support Prize/
PT  - Journal Article
DEP - 20231128
PL  - United States
TA  - Epilepsia
JT  - Epilepsia
JID - 2983306R
SB  - IM
MH  - Adult
MH  - Humans
MH  - Retrospective Studies
MH  - Prognosis
MH  - Hospital Mortality
MH  - Severity of Illness Index
MH  - *Status Epilepticus/therapy
MH  - Seizures
MH  - Electroencephalography
OTO - NOTNLM
OT  - EMSE
OT  - END-IT
OT  - ICU EEG
OT  - NCSE
OT  - SACE
OT  - STESS
OT  - status epilepticus
EDAT- 2023/11/15 06:42
MHDA- 2024/01/15 12:43
CRDT- 2023/11/15 05:30
PHST- 2023/11/11 00:00 [revised]
PHST- 2023/09/18 00:00 [received]
PHST- 2023/11/13 00:00 [accepted]
PHST- 2024/01/15 12:43 [medline]
PHST- 2023/11/15 06:42 [pubmed]
PHST- 2023/11/15 05:30 [entrez]
AID - 10.1111/epi.17830 [doi]
PST - ppublish
SO  - Epilepsia. 2024 Jan;65(1):138-147. doi: 10.1111/epi.17830. Epub 2023 Nov 28.