Mitchell James W, Kallis Constantinos, Dixon Peter A, Grainger Ruth, Marson Anthony G
The Walton Centre NHS Trust, Liverpool, UK
University of Liverpool, Liverpool, UK.
Clin Med (Lond). 2020 Mar;20(2):178-182. doi: 10.7861/clinmed.2019-0303.
Approximately 1.4% of emergency medical admissions are due to epileptic seizures. For the majority of such cases, computed tomography (CT) will not inform acute management and is unnecessary.Pseudonymised, routinely collected data from seven hospitals within the Cheshire and Merseyside area of the UK were analysed. All patients with emergency admissions to hospital due to seizures between 2014 and 2017 were included. Use of CT of the head was identified from routine coding.We identified 4,183 individuals with an acute seizure admission, of which over 30% received a CT of the head. There was significant variation in CT among hospital trusts.The rate of CT for patients admitted with seizures is high and CT is not being directed to those where they may be indicated. Integrated care pathways and guidelines are required to improve the management of patients presenting acutely with seizures.
大约1.4%的急诊入院病例是由癫痫发作导致的。对于大多数此类病例，计算机断层扫描（CT）对急性治疗并无指导作用且没有必要。对英国柴郡和默西塞德郡地区七家医院常规收集的匿名数据进行了分析。纳入了2014年至2017年间因癫痫发作而急诊入院的所有患者。通过常规编码确定头部CT的使用情况。我们确定了4183例急性癫痫发作入院患者，其中超过30%接受了头部CT检查。医院信托之间的CT检查率存在显著差异。癫痫发作入院患者的CT检查率很高，但CT检查并未针对可能需要的患者。需要综合护理路径和指南来改善急性癫痫发作患者的管理。
