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

Introduction: Scoring systems to predict outcomes in pediatric status epilepticus (SE) are limited. We sought to assess usefulness of the END-IT score in pediatric SE.

Methodology: We conducted a retrospective study at a tertiary hospital in New Delhi, India. Children aged 1 month-18 years who presented with seizure for ≥5 min/actively convulsing to emergency were enrolled. END-IT score was calculated and correlated with outcome at discharge using Pediatric Overall Performance Category (POPC) scale, in-hospital mortality, and progression to refractory and super-refractory SE (SRSE).

Results: We enrolled 140 children (mean age 5.8 years; 67.1% males). Seven children died and 15 had unfavorable outcomes. The predictive accuracy of END-IT at a cutoff of > 2: for unfavorable outcome (POPC score ≥3) was: sensitivity 0.73 (95% CI: 0.45-0.92), specificity 0.94 (95% CI: 0.89-0.98), PPV 0.61 (95% CI: 0.36-0.83), NPV 0.97 (95% CI: 0.92-0.99), positive likelihood ratio (13.09), F1 score (0.666); for death: sensitivity 0.86 (95% CI: 0.42-0.99), specificity 0.91 (95% CI: 0.85-0.95), PPV 0.33 (95% CI: 0.13-0.59), NPV 0.99 (95% CI: 0.96-1.00), F1 score (0.48); for RSE: sensitivity 0.80 (95%CI: 0.28-0.99), specificity 0.90 (95% CI: 0.83-0.94), PPV 0.22 (95% CI: 0.06-0.48) NPV 0.99 (95% CI: 0.96-1.00), F1 score (0.35); for SRSE: sensitivity 0.67 (95% CI: 0.22-0.96) specificity 0.75 (95% CI: 0.66-0.82), PPV 0.22 (95% CI: 0.06-0.48) NPV 0.98 (95% CI: 0.94-0.99), F1 score (0.33).

Conclusion: We demonstrate utility of the END-IT score to predict short-term outcomes as well as progression to refractory and SRSE for the first time among children with SE.