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A new scoring model for outcomes in neonates with seizures: ENEOSS (Ege Neonatal Seizure Scoring Model)

Objectives (1) To determine the value of a set of independent risk factors for adverse neurologic outcomes at the onset of neonatal seizures. (2) To design an evidence-based scoring system that could assist in predicting outcomes at the onset of neonatal seizures. Methods. A total of 77 preterm and term neonates with seizures, who had been followed up at Ege University Children’s Hospital NICU in 2013-2017, were included the study. A neurodevelopmental outcome was determined by a developmental screening test at the postconceptional 12th month. We performed a statistical analysis to identify variables associated with adverse outcomes and to develop a scoring system that could provide early prognostic indications. Results: An adverse neurologic outcome was defined in 45.9% (40/77) of infants. Five variables were identified as the most significant independent risk factors for setting up a scoring system for the adverse outcome (p<0.01): gestational age, birth weight, etiology, neuroimaging, and electroencephalography grade. Each variable was scored from 0 to 4 to represent the range from "normal" to "severely abnormal." The total score was calculated by adding the scores of the five variables. This score ranged from 0 to 16. A cut-off score of 10.5 provided the greatest predictive values for the adverse outcome (The area under curve:72.2, figure1): sensitivity;84.6%, specificity;52.5%, PPV:63.4%, NPV:77.7%. Conclusion The presented scoring system is an easy and reliable new tool for overall neurological outcomes in newborns with neonatal seizures.