Hypoalbuminemia excellent prognostic biomarker for mortality in status epilepticus unravels study

Key Findings

Mortality Rates:

• Among the 496 patients, 46 (9.3%) died during hospitalization.

• Follow-up data at six months were available for 364 patients, and among them, 86 (23.6%) had died.

Hypoalbuminemia and Mortality:

• Hypoalbuminemia independently correlated with in-hospital mortality (p=0.005, OR=3.35, 95% CI=1.43–7.86) and 6-month mortality (p=0.001, OR=3.59, 95% CI=1.75–7.35).

STESS vs. A-STESS:

• The original STESS had an AUC of 0.754 (95% CI=0.656–0.836) for in-hospital mortality prediction and 0.684 (95% CI=0.613–0.755) for 6-month mortality.

• A-STESS significantly improved predictive accuracy with an AUC of 0.837 (95% CI=0.760–0.916; p=0.002) for in-hospital mortality and 0.739 (95% CI=0.688–0.826; p=0.033) for 6-month mortality.

A-STESS Performance:

• An A-STESS score of ≥3 showed optimal balance between sensitivity and specificity for mortality prediction:

• In-hospital mortality: Sensitivity=0.88, Specificity=0.68, Accuracy=0.70

• 6-month mortality: Sensitivity=0.67, Specificity=0.73, Accuracy=0.72

This study demonstrates that hypoalbuminemia is an excellent prognostic biomarker for mortality in status epilepticus. It was found that the integration of hypoalbuminemia into the STESS scoring system significantly increases the predictive power of STESS for both short and long-term outcomes. It would be useful to find therapeutic interventions like albumin supplementation that improve patient outcome in future research by validation of the A-STESS model.

Reference:

Misirocchi F, Quintard H, Rossetti AO, Florindo I, Sarbu OE, Kleinschmidt A, Schaller K, Seeck M, De Stefano P. Hypoalbuminemia in status epilepticus is a biomarker of short- and long-term mortality: A 9-year cohort study. Eur J Neurol. 2025 Jan;32(1):e16573. doi: 10.1111/ene.16573. PMID: 39711115; PMCID: PMC11664120.