Seizures and emergency department: characteristics and factors of repeat adult attendees

ORCID

Abstract

Background: To identify risk factors and characteristics for the repeated attendance at an emergency department (ED) following a seizure. Methods: A retrospective cohort study was conducted using non-identifiable data of individuals attending ED at least twice between 2015 and 2018, following a seizure. Data were drawn from the patient administration system of an English rural medium-sized teaching district general hospital emergency department (ED), serving a population of 566,000 people. It was analysed for bio-psycho-social features associated with repeat attendances. Results: Of 3522 seizure-related attendances in the four years, 450 people were identified to be repeaters attending on two or more occasions (range 2–12). Just over a quarter (27%) were 18–29 years old. Higher likelihood of re-attendance was associated with social deprivation and no fixed abode. Mental illness was a significant co-morbidity influencing repeat attendances. Nearly half (47%) had no recorded anti-seizure medication (ASM). Three fifth (60%) were on general medication and a quarter (25%) on psychotropics. Nearly a quarter (22%) had alcohol and recreational drug concerns. Just over a quarter (28%) had no previous epilepsy diagnosis. Nearly a fifth (n = 85, 19%) died during the study period. Conclusion: People who present repeatedly with seizures at ED are at significant risk of death over a four-year period and require pro-active clinical follow-up. People who are homeless or from socially deprived areas are over-represented in this group, as are those with alcohol problems, co-morbid mental health conditions and compliance issues. This suggests enhanced targeted intervention for this cohort is needed.

DOI

10.1007/s00415-022-11006-0

Publication Date

2022-02-13

Publication Title

Journal of Neurology

Volume

269

Issue

7

ISSN

0340-5354

Embargo Period

9999-12-31

Keywords

Compliance, Deprivation, Emergency department, Epilepsy attendances

First Page

3770

Last Page

3778

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This item is under embargo until 31 December 9999

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