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Hemispherectomy Outcome Prediction Scale: Development and validation of a seizure freedom prediction tool
Author(s) -
Weil Alexander G.,
Lewis Evan C.,
Ibrahim George M.,
Kola Olivia,
Tseng ChiHong,
Zhou Xinkai,
Lin KaoMin,
Cai LiXin,
Liu QingZhu,
Lin JiuLuan,
Zhou WenJing,
Mathern Gary W.,
Smyth Matthew D.,
O'Neill Brent R.,
Dudley Roy,
Ragheb John,
Bhatia Sanjiv,
Delev Daniel,
Ramantani Georgia,
Zentner Josef,
Ojemann Jeffrey,
Wang Anthony C.,
Dorfer Christian,
Feucht Martha,
Czech Thomas,
Bollo Robert J.,
Issabekov Galymzhan,
Zhu Hongwei,
Connelly Mary,
Steinbok Paul,
Zhang JianGuo,
Zhang Kai,
Hidalgo Eveline Teresa,
Weiner Howard L.,
WongKisiel Lily,
LapalmeRemis Samuel,
Tripathi Manjari,
Sarat Chandra Poodipedi,
Hader Walter,
Wang FengPeng,
Yao Yi,
Olivier Champagne Pierre,
Guo Qiang,
Li ShaoChun,
Budke Marcelo,
PérezJiménez Maria Angeles,
Raftapoulos Christian,
Finet Patrice,
Michel Pauline,
Schaller Karl,
Stienen Martin N.,
Baro Valentina,
Cantillano Malone Christian,
Pociecha Juan,
Chamorro Noelia,
Muro Valeria L.,
Lehe Marec,
Vieker Silvia,
Oluigbo Chima,
Gaillard William D.,
Al Khateeb Mashael,
Al Otaibi Faisal,
Krayenbühl Niklaus,
Bolton Jeffrey,
Pearl Phillip L.,
Fallah Aria
Publication year - 2021
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.16861
Subject(s) - hemispherectomy , semiology , logistic regression , epilepsy surgery , epilepsy , psychology , surgery , medicine , psychiatry
Objective To develop and validate a model to predict seizure freedom in children undergoing cerebral hemispheric surgery for the treatment of drug‐resistant epilepsy. Methods We analyzed 1267 hemispheric surgeries performed in pediatric participants across 32 centers and 12 countries to identify predictors of seizure freedom at 3 months after surgery. A multivariate logistic regression model was developed based on 70% of the dataset (training set) and validated on 30% of the dataset (validation set). Missing data were handled using multiple imputation techniques. Results Overall, 817 of 1237 (66%) hemispheric surgeries led to seizure freedom (median follow‐up = 24 months), and 1050 of 1237 (85%) were seizure‐free at 12 months after surgery. A simple regression model containing age at seizure onset, presence of generalized seizure semiology, presence of contralateral 18‐fluoro‐2‐deoxyglucose–positron emission tomography hypometabolism, etiologic substrate, and previous nonhemispheric resective surgery is predictive of seizure freedom (area under the curve = .72). A Hemispheric Surgery Outcome Prediction Scale (HOPS) score was devised that can be used to predict seizure freedom. Significance Children most likely to benefit from hemispheric surgery can be selected and counseled through the implementation of a scale derived from a multiple regression model. Importantly, children who are unlikely to experience seizure control can be spared from the complications and deficits associated with this surgery. The HOPS score is likely to help physicians in clinical decision‐making.