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

Lennard, Sarah; Henley, William; McLean, Brendan; Allard, Jon; Parrett, Mary; Jadav, Mark; Laugharne, Richard; Shankar, Rohit

doi:10.1007/s00415-022-11006-0

Cited by 3 publications

(5 citation statements)

References 17 publications

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“…Four other studies reported a prevalence of homelessness among PWE between 1.8 and 4% (Rimmer et al 2007 ; Gabriel et al 2020 ; Ramamurthy et al 2021 ; Lennard et al 2022 ).…”

Section: Resultsmentioning

confidence: 97%

“…Three different studies found that homeless people had an early readmission rate more than 2 times higher than the housed population (Rosendale et al 2019 ; Lennard et al 2022 ; Subedi et al 2022 ). Rosendale et al ( 2019 ) and Subedi et al ( 2022 ) described epilepsy and homelessness are both risk factors for early hospital readmission.…”

Section: Resultsmentioning

confidence: 99%

“…Subedi et al ( 2022 ) reported 35% higher readmission rate for epilepsy in homeless people. Lennard et al ( 2022 ) uncovered 12.78% readmissions for seizures, with minimum attendance of 2 and maximum of 12 readmissions over a four-year period, with nearly half of the admittees lacking a former prescription of antiseizure medication.…”

Section: Resultsmentioning

confidence: 99%

“…Alcoholism is a known risk factor for epilepsy. Lennard et al ( 2022 ) studied a group of people with repeat hospital admissions after a seizure episode and encountered 12% of drug or alcohol induced seizures.…”

Section: Discussionmentioning

confidence: 99%

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The homeless, seizures, and epilepsy: a review

Pontes Silva,

Gama Marques

2023

J Neural Transm

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This review aims to estimate the prevalence of seizures and epilepsy among homeless people in current literature as well as understand the main adversities that this group withstands. We conducted a search for “epilep*”, “seizur*”, and “homeles*” in titles and abstracts of articles in PubMed. Overall, 25 articles met the final inclusion criteria and warranted analyses. This study suggests that the prevalence of epilepsy in the homeless population is between 2 and 30%, whereas the prevalence of homelessness in people with epilepsy is between 2 and 4%. Every study included in this review corroborates the increased prevalence of seizures and epilepsy among the homeless, which puts them at risk for worse outcomes related to this condition and numerous associated comorbidities. Further evidence is needed to clarify the distinction of primary and secondary seizures in this group, which shows a high rate of confounding factors for seizures like substance abuse or withdrawal and head injury, and to decrease the burden of epilepsy and homelessness in an already resource-deficient community.

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“…Four other studies reported a prevalence of homelessness among PWE between 1.8 and 4% (Rimmer et al 2007 ; Gabriel et al 2020 ; Ramamurthy et al 2021 ; Lennard et al 2022 ).…”

Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The homeless, seizures, and epilepsy: a review

Pontes Silva,

Gama Marques

2023

J Neural Transm

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“…Approximately one fourth of the patients used EMS and ED services at least twice during the study period. Repeated use, 12.8%–60% in earlier studies [26, 27, 30, 31], has been linked to poor insurance status, problems in further treatment [32], male gender, and alcohol abuse [30]. Further studies are needed to properly identify and characterize repeated users to provide adequate support for this patient group and thus reduce the burden on the system.…”

Section: Discussionmentioning

confidence: 99%

Burden of suspected epileptic seizures on emergency services: A population‐based study

Kämppi

Puolakka

Ritvanen

et al. 2023

Euro J of Neurology

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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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