The ACD (age, consciousness, duration) can help to predict the survival of a patient with status epilepticus. This can help to identify a patient who may require more aggressive management. The authors are from multiple institutions in Denmark, Norway and Germany.
Patient selection: age >= 18 years, status epilepticus, discharged alive
Parameters:
(1) age in years (A)
(2) level of consciousness at admission (C)
(3) duration of status epilepticus in hours (D)
Parameter
Finding
Points
age in years
<= 40 years
0
41 to 60 years
2
61 to 80 years
4
>= 80 years
6
level of consciousness
awake
0
somnolent
0
stuporous
2
comatose
2
duration of episode
< 1 hour
0
1 to 2 hours
1
3 to 6 hours
2
7 to 19 hours
3
20 to 54 hours
4
55 to 149 hours
5
150 to 399 hours
6
>= 400 hours
7
total scores =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 15
Additional prognostic factors:
(1) difference in NIHSS score before status epilepticus to first follow-up
(2) presence of new neurological deficits
Score
Risk Group
0 or 1
1
2 or 3
2
4 or 5
3
6 or 7
4
8 or 9
5
10 or 11
6
12 or 13
7
14 or 15
8
Performance:
• The area under the ROC curve is 0.78.
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