Status epilepticus in pediatric patients severity score to predict outcome of children with status epilepticus – A step ahead?

Background: Abstract status epilepticus (SE) outcome is influenced by etiology, treatment delays, and seizure refractoriness. Identifying predictors of outcome is crucial for guiding management. In adults, the SE Severity Score has shown utility, and its pediatric modification, status epilepticus in pediatric patients severity score (STEPSS), was evaluated in this study. Aims and Objectives: The aims and objectives of the study are to assess the predictive accuracy of STEPSS as a baseline clinical score for short-term outcomes in children with SE. Materials and Methods: A prospective study was conducted from September 2022 to March 2024, enrolling children aged 1 month–14 years presenting with seizures ≥5 min or convulsions at emergency admission. STEPSS was calculated at admission. Outcomes included mortality, pediatric overall performance category (POPC) at discharge, and treatment response. Diagnostic utility of STEPSS for unfavorable outcome was analyzed. Results: Of 147 children (82 male), 34% were aged 1 month–2 years and 66% were 2–14 years. Twenty-three children died, while 120 were discharged. At a STEPSS cutoff >3, sensitivity for unfavorable outcome (POPC ≥3) was 87.27% (95% confidence interval [CI]: 75.52–94.73), specificity 82.61% (95% CI: 73.30–89.72), positive predictive value 5.02% (95% CI: 3.18–7.92), and negative predictive value 91.57% (95% CI: 84.38–95.62). Conclusion: STEPSS >3 demonstrated good predictive accuracy for unfavorable outcomes, with high sensitivity for mortality. As a simple bedside tool, STEPSS is valuable for predicting outcome and treatment response in pediatric SE.