Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
Epileptic Disord. 2023 Apr;25(2):150-159. doi: 10.1002/epd2.20001. Epub 2023 Apr 29.
Status epilepticus (SE) is a common neurological emergency with unsatisfying prognoses, and accurate prediction of functional outcome is beneficial in clinical decision-making. The relationship between serum albumin concentration and outcome of SE patients has yet to be unveiled.
Clinical profiles of SE patients admitted to Xiangya Hospital, Central South University, from April 2017 to November 2020, were analyzed retrospectively. Outcomes of SE patients at discharge were divided into two groups based on the modified Rankin Scale (mRS): favorable outcome (mRS: 0-3) and unfavorable outcome (mRS: 4-6).
Fifty-one patients were enrolled. Unfavorable functional outcome at discharge was reported in 60.8% (31/51). Serum albumin concentration at admission and the Encephalitis-NCSE-Diazepam resistance-Image abnormalities-Tracheal intubation (END-IT) score remained independent predictors for functional outcome of SE patients. A lower albumin concentration at admission and higher END-IT score indicated a higher chance of unfavorable outcome for SE patients. The cut-off value of serum albumin to predict unfavorable outcome was 35.2 g/L, with a sensitivity of 67.7% and specificity of 85.0%, and an area under the receiver operating characteristic curve (ROC) of .738 (95% CI: .600-.876, p = .004). The preferable END-IT score with optimal sensitivity (74.2%) and specificity (60%) was 2 and the area under the ROC was .742, with 95% CI of .608-.876 (p = .004).
Serum albumin concentration at admission and the END-IT score are two independent predictive factors for short-term outcome of SE patients, moreover, the serum albumin concentration is not inferior to the END-IT score in indicating functional outcome at discharge.
癫痫持续状态（SE）是一种常见的神经系统急症，预后不佳，准确预测功能结局有助于临床决策。血清白蛋白浓度与 SE 患者结局之间的关系尚未阐明。
回顾性分析 2017 年 4 月至 2020 年 11 月中南大学湘雅医院收治的 SE 患者的临床资料。根据改良 Rankin 量表（mRS）将 SE 患者出院时的结局分为两组：良好结局（mRS：0-3）和不良结局（mRS：4-6）。
共纳入 51 例患者，出院时不良功能结局发生率为 60.8%（31/51）。入院时血清白蛋白浓度和脑炎-非惊厥性 SE-地西泮耐药-影像异常-气管插管（END-IT）评分是 SE 患者功能结局的独立预测因素。入院时血清白蛋白浓度越低、END-IT 评分越高，SE 患者不良结局的可能性越大。预测不良结局的血清白蛋白截断值为 35.2 g/L，其敏感性为 67.7%，特异性为 85.0%，ROC 曲线下面积为 0.738（95%CI：0.600-0.876，p=0.004）。敏感性（74.2%）和特异性（60%）最佳的 END-IT 评分是 2，ROC 曲线下面积为 0.742，95%CI 为 0.608-0.876（p=0.004）。
入院时血清白蛋白浓度和 END-IT 评分是 SE 患者短期结局的两个独立预测因素，且血清白蛋白浓度在预测出院时功能结局方面不劣于 END-IT 评分。
