score_2helps2b: 2HELPS2B Score for Inpatient Seizure Risk

In cliot: Clinical Indices and Outcomes Tools

2HELPS2B Score for Inpatient Seizure Risk

Description

Calculates the 2HELPS2B score to estimate the risk of seizures in hospitalized patients undergoing continuous EEG (cEEG). Validated by Struck et al., this score uses clinical history and specific EEG findings (usually from the first hour of recording) to stratify patients into low, medium, or high risk, guiding the duration of monitoring.

Usage

score_2helps2b(frequency_gt_2hz, sporadic_discharges, lpd_lrda_bipd,
               plus_features, prior_seizure, bird)

Arguments

frequency_gt_2hz	Numeric (0 or 1). Presence of any periodic or rhythmic pattern with frequency > 2.0 Hz (excluding Generalized Rhythmic Delta Activity/GRDA). (+1 point).
sporadic_discharges	Numeric (0 or 1). Presence of independent sporadic epileptiform discharges. (+1 point).
lpd_lrda_bipd	Numeric (0 or 1). Presence of Lateralized Periodic Discharges (LPDs), Lateralized Rhythmic Delta Activity (LRDA), or Bilateral Independent Periodic Discharges (BIPDs). (+1 point).
plus_features	Numeric (0 or 1). Presence of "Plus" features (superimposed rhythmic, sharp, or fast activity). (+1 point).
prior_seizure	Numeric (0 or 1). History of prior seizure (acute or remote). (+1 point).
bird	Numeric (0 or 1). Presence of Brief Potentially Ictal Rhythmic Discharges (BIRDs). (+2 points).

Value

A list containing:

Score	The calculated 2HELPS2B score (Range 0-7).
Risk_Category	Risk classification (Low, Medium, or High).
Seizure_Risk_Percentage	Estimated probability of seizure activity (e.g., "5%", "12%", "27%", etc.).
Recommended_Monitoring	Suggested duration of cEEG based on risk (1 hour, 12 hours, or 24+ hours).

References

Struck AF, et al. Assessment of the Validity of the 2HELPS2B Score for Inpatient Seizure Risk Prediction. JAMA Neurol. 2020;77(4):500-507. doi:10.1001/jamaneurol.2019.4656

Examples

# Example 1: High Risk Patient
# LPDs present (+1), Plus features (+1), Prior seizure (+1) = Score 3
score_2helps2b(0, 0, 1, 1, 1, 0)

# Example 2: Low Risk Patient
# No abnormalities, no history of seizure = Score 0
score_2helps2b(0, 0, 0, 0, 0, 0)

# Example 3: Very High Risk
# BIRDs present (+2), Frequency > 2Hz (+1) = Score 3
score_2helps2b(1, 0, 0, 0, 0, 1)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.