Development and validation of a nomogram for the estimation of the prognosis of patients presenting with a febrile seizure
Development and validation of a nomogram for the estimation of the prognosis of patients presenting with a febrile seizure

Development and validation of a nomogram for the estimation of the prognosis of patients presenting with a febrile seizure

BMC Pediatr. 2024 Oct 12;24(1):655. doi: 10.1186/s12887-024-05132-z.

ABSTRACT

BACKGROUND: Febrile seizures constitute a prevalent emergency in early childhood. Previous studies indicated that certain febrile seizures in children may progress to epilepsy, exerting a substantial impact on children’s health and developmental trajectory. The objective of this study was to formulate a predictive nomogram to assess the likelihood of transitioning from febrile seizures to epilepsy in pediatric patients, thereby facilitating informed decisions regarding medical interventions for febrile seizures.

METHODS: A total of 306 patients were enrolled and categorized into training (70%) and test (30%) cohorts. Clinical characteristics were subjected to comparison utilizing chi-squared and t tests. Multivariate logistic regression was employed to identify significant factors for predicting the risk of transitioning from febrile seizures to epilepsy, leading to the development of a nomogram. The nomogram’s performance was assessed through receiver operating characteristic curves, calibration, and decision curve analysis.

RESULTS: Predictive factors associated with the transition to epilepsy encompassed lower Na, elevated RDW, IL-6, and increased background slow rhythm and epileptiform discharges in EEG. The nomogram, incorporating five factors, exhibited commendable predictive value (AUC train = 0.812, AUC test = 0.791) for assessing the risk of transitioning from febrile seizures to epilepsy. Calibration analyses confirmed reliability, and decision curve analysis underscored its clinical utility.

CONCLUSIONS: Lower Na, elevated RDW, IL-6, background slow rhythm, and epileptiform discharges are associated with the risk of transitioning from febrile seizures to epilepsy. The nomogram stands as a valuable tool for predicting this risk, aiding in the strategic implementation of medical interventions to enhance outcomes for patients with febrile seizures.

PMID:39395948 | DOI:10.1186/s12887-024-05132-z