Table 4. Mixed effects multiple linear regression model for the pediatric population using the Hague Seizure Severity Scale.

The table presents the estimated effects of vagus nerve stimulation surgeries and revisions on HSSS scores for pediatric patients and those with impaired cognitive and communicative abilities. The baseline HSSS score (HSSS0) before any intervention was 31.36. After the initial VNS installation (HSSS1), there was a significant reduction of 5 points (p < 0.001). Further decreases in HSSS scores were observed with subsequent revisions: an 8.07-point reduction after the first revision (HSSS2), an 11.23-point reduction after the second revision (HSSS3), and a 13.8-point reduction after the third revision (HSSS4). These reductions were all statistically significant, with p-values less than 0.05. These results indicate that VNS surgery and subsequent revisions are associated with progressively reduced seizure severity in the pediatric and cognitively impaired population, demonstrating the effectiveness of VNS therapy across multiple interventions.

HSSS: Hague Seizure Severity Scale (representing corresponding score); CI: confidence interval

Predictors	HSSS estimations	CI	p-value
Reference HSSS (HSSS0)	31.36	(25.72 to 36.99)	<0.001
Installation (HSSS1)	-5	(-5.00 to -5.00)	<0.001
1st revision (HSSS2)	-8.07	(-12.04 to -4.10)	<0.001
2nd revision (HSSS3)	-11.23	(-16.77 to -5.69)	<0.001
3rd revision (HSSS4)	-13.8	(-25.13 to -2.48)	0.022