Clinical profile and outcome prediction in children with Status Epilepticus using STEPSS : Status Epilepticus in Paediatric patients Severity Score

This project is a prospective, longitudinal study titled Clinical profile and outcome prediction in children with Status Epilepticus using STEPSS Status Epilepticus in Paediatric patients Severity Score.

The aim is to determine the clinical characteristics and estimate the short term outcome of Status Epilepticus SE using the STEPSS score in children aged 1 month to 18 years admitted to the Paediatric Intensive Care Unit PICU at Kasturba Hospital Manipal.

The primary objective is to estimate the short term outcome of SE using the STEPSS score. The secondary objectives include determining demographic and clinical factors associated with SE and estimating disability at the time of discharge using the Functional Status Scale FSS.

The study is justified by the need to identify local etiological factors and optimize clinical care for children with SE, using a simple, validated tool like STEPSS for early risk stratification and outcome prediction.

Children between 1 month and 18 years with SE admitted to the PICU at Kasturba Hospital, Manipal, will be included, excluding those with psychogenic non epileptic seizures.

The estimated sample size is 126 and study period between August 2025 to March 2027. The study will use the Status Epilepticus in Paediatric patients Severity Score STEPSS for outcome prediction and the Functional Status Scale FSS to assess disability at discharge. After obtaining Institutional Ethics Committee and CTRI approvals, informed consent will be taken from parents. Clinical data, including demographics, history, physical and neurological examinations, and the STEPSS score will be recorded at admission. Disability at discharge will be assessed using the FSS, with a favourable outcome for children with pre-morbid disability defined as a return to their baseline functional status. Statistical methods will include descriptive statistics, tests for data normality Shapiro-Wilk or Kolmogorov-Smirnov, and the application of parametric or non-parametric tests as appropriate. Predictive accuracy of STEPSS will be tested by calculating specificity, sensitivity, Positive Predictive Value , and Negative Predictive Value , as well as F1 scores. The optimal cut off point will be determined using the Receiver Operating Characteristic curve and Youden’s index.

Written informed consent will be obtained from parents, and confidentiality will be maintained by not collecting patient details such as name, address, or contact details. The study will not involve any cost as the required EEG is part of the routine standard of care for children with SE.The study is expected to provide better insight into the clinical profile and outcomes of SE using STEPSS and FSS.