Burden of suspected epileptic seizures on emergency services : a population-based study
Kämppi, Leena; Puolakka, Tuukka; Ritvanen, Jaakko; Tuppurainen, Kati; Päkkilä, Jari; Kuisma, Markku; Peltola, Jukka (2023-04-07)
Kämppi, L, Puolakka, T, Ritvanen, J, et al. Burden of suspected epileptic seizures on emergency services: A population-based study. Eur J Neurol. 2023; 30: 2197-2205. doi:10.1111/ene.15800
© 2023 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
https://creativecommons.org/licenses/by-nc-nd/4.0/
https://urn.fi/URN:NBN:fi-fe20231002138117
Tiivistelmä
Abstract
Background and purpose: Patients with acute epileptic seizures form a large patient group in emergency neurology. This study aims to determine the burden caused by suspected epileptic seizures at different steps in emergency care.
Methods: A retrospective, cross-sectional, population-based (>1,000,000 inhabitants), 4-year (2015–2018) study was conducted in an urban setting with a single dispatch centre, a university hospital-affiliated emergency medical service (EMS), and five emergency departments (EDs). The study covered all adult (≥16 years old) emergency neurology patients receiving medical attention due to suspected epileptic seizures from the EMS and EDs and during hospital admissions in the Helsinki metropolitan area.
Results: Epileptic seizures were suspected in 14,364 EMS calls, corresponding to 3.3% of all EMS calls during the study period. 9,112 (63.4%) cases were transported to hospital due to suspected epileptic seizures, and 3368 (23.4%) were discharged on the scene. 6969 individual patients had 11,493 seizure-related ED visits, accounting for 3.1% of neurology- and internal medicine-related ED visits and 4607 hospital admissions were needed with 3 days’ median length of stay (IQR=4, Range 1–138). Male predominance was noticeable at all stages (EMS 64.7%, EDs 60.1%, hospital admissions 56.2%). The overall incidence was 333/100,000 inhabitants/year for seizure-related EMS calls, 266/100,000 inhabitants/year for ED visits and 107/100,000 inhabitants/year for hospital admissions. Total estimated costs were 6.8 million €/year, corresponding to 0.5% of all specialized healthcare costs in the study area.
Conclusions: Patients with suspected epileptic seizures cause a significant burden on the health care system. Present-day epidemiological data are paramount when planning resource allocation in emergency services.
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