Dataset Information

Assessment of the Validity of the 2HELPS2B Score for Inpatient Seizure Risk Prediction.

ABSTRACT:

Importance

Seizure risk stratification is needed to boost inpatient seizure detection and to improve continuous electroencephalogram (cEEG) cost-effectiveness. 2HELPS2B can address this need but requires validation.

Objective

To use an independent cohort to validate the 2HELPS2B score and develop a practical guide for its use.

Design, setting, and participants

This multicenter retrospective medical record review analyzed clinical and EEG data from patients 18 years or older with a clinical indication for cEEG and an EEG duration of 12 hours or longer who were receiving consecutive cEEG at 6 centers from January 2012 to January 2019. 2HELPS2B was evaluated with the validation cohort using the mean calibration error (CAL), a measure of the difference between prediction and actual results. A Kaplan-Meier survival analysis was used to determine the duration of EEG monitoring to achieve a seizure risk of less than 5% based on the 2HELPS2B score calculated on first- hour (screening) EEG. Participants undergoing elective epilepsy monitoring and those who had experienced cardiac arrest were excluded. No participants who met the inclusion criteria were excluded.

Main outcomes and measures

The main outcome was a CAL error of less than 5% in the validation cohort.

Results

The study included 2111 participants (median age, 51 years; 1113 men [52.7%]; median EEG duration, 48 hours) and the primary outcome was met with a validation cohort CAL error of 4.0% compared with a CAL of 2.7% in the foundational cohort (P?=?.13). For the 2HELPS2B score calculated on only the first hour of EEG in those without seizures during that hour, the CAL error remained at less than 5.0% at 4.2% and allowed for stratifying patients into low- (2HELPS2B?=?0; <5% risk of seizures), medium- (2HELPS2B?=?1; 12% risk of seizures), and high-risk (2HELPS2B, ?2; risk of seizures, >25%) groups. Each of the categories had an associated minimum recommended duration of EEG monitoring to achieve at least a less than 5% risk of seizures, a 2HELPS2B score of 0 at 1-hour screening EEG, a 2HELPS2B score of 1 at 12 hours, and a 2HELPS2B score of 2 or greater at 24 hours.

Conclusions and relevance

In this study, 2HELPS2B was validated as a clinical tool to aid in seizure detection, clinical communication, and cEEG use in hospitalized patients. In patients without prior clinical seizures, a screening 1-hour EEG that showed no epileptiform findings was an adequate screen. In patients with any highly epileptiform EEG patterns during the first hour of EEG (ie, a 2HELPS2B score of ?2), at least 24 hours of recording is recommended.

SUBMITTER: Struck AF

PROVIDER: S-EPMC6990873 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Assessment of the Validity of the 2HELPS2B Score for Inpatient Seizure Risk Prediction.

Struck Aaron F AF Tabaeizadeh Mohammad M Schmitt Sarah E SE Ruiz Andres Rodriguez AR Swisher Christa B CB Subramaniam Thanujaa T Hernandez Christian C Kaleem Safa S Haider Hiba A HA Cissé Abbas Fodé AF Dhakar Monica B MB Hirsch Lawrence J LJ Rosenthal Eric S ES Zafar Sahar F SF Gaspard Nicholas N Westover M Brandon MB

JAMA neurology 20200401 4

<h4>Importance</h4>Seizure risk stratification is needed to boost inpatient seizure detection and to improve continuous electroencephalogram (cEEG) cost-effectiveness. 2HELPS2B can address this need but requires validation.<h4>Objective</h4>To use an independent cohort to validate the 2HELPS2B score and develop a practical guide for its use.<h4>Design, setting, and participants</h4>This multicenter retrospective medical record review analyzed clinical and EEG data from patients 18 years or older ...[more]

PMID: 31930362

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Dataset Information

Assessment of the Validity of the 2HELPS2B Score for Inpatient Seizure Risk Prediction.

Importance

Objective

Design, setting, and participants

Main outcomes and measures

Results

Conclusions and relevance

Publications

Assessment of the Validity of the 2HELPS2B Score for Inpatient Seizure Risk Prediction.

Similar Datasets

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