• Emergencias · Jun 2024

    Multicenter Study Observational Study

    Identifying risk for status epilepticus with the ADAN scale: a prospective multicenter validation study.

    • Juan Luis Restrepo-Vera, Jacint Sala-Padró, Beatriz Parejo-Carbonell, Jordi Ciurans, Juan Luis Becerra, Misericòrdia Veciana, Daniel Campos, Irene García-Morales, Manuel Quintana, and Estevo Santamarina.
    • Unidad de Epilepsia, Departamento de Neurología, Hospital Vall d'Hebron, Barcelona, España.
    • Emergencias. 2024 Jun 1; 36 (3): 197203197-203.

    ObjectivesStatus epilepticus (SE) is a serious event associated with high mortality. This study aims to validate the recently developed ADAN (Abnormal speech, ocular Deviation, Automatisms, and Number of motor epileptic seizures) scale for detecting high risk for SE.Material And MethodsProspective, multicenter, observational study in adults with suspected epileptic seizures. Consecutive recruitment took place over a 27-month period in 4 hospital emergency departments (EDs). The main endpoint was the proportion of patients with criteria for SE based on the collection and analysis of clinical characteristics and the ADAN scale criteria on arrival at the ED.ResultsOf the 527 patients recruited, 203 (38.5%) fulfilled the criteria that predicted SE. Multiple regression analysis demonstrated that the 4 ADAN criteria were the only variables independently associated with a final diagnosis of SE (P .001). The predictive power of the scale was 90.9% (95% CI, 88.4%-93.4%) for a final SE diagnosis. We established 3 risk groups based on ADAN scores: low (score, 0-1: 8.7%), moderate (2, 46.6%), and high (> 2, 92.6%). A cut point of more than 1 had a sensitivity of 88.2% for predicting SE, specificity of 77.8%, positive predictive value of 71.3%, and negative predictive value of 91.3%.ConclusionThe ADAN scale is a prospectively validated, simple clinical tool for identifying patients in the ED who are at high risk for SE.

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