Boston Medical Center, 1 Boston Medical Center Place, Boston, MA, USA.
Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Pediatric Neurology Unit, Department of Pediatrics, Hospital Universitari Son Espases, Universitat de les Illes Balears, Palma, Spain.
Seizure. 2021 Apr;87:7-16. doi: 10.1016/j.seizure.2021.02.020. Epub 2021 Feb 16.
To describe the epidemiology and health resource utilization for convulsive status epilepticus (SE) in the emergency department (ED).
Retrospective descriptive study in the Nationwide Emergency Department Sample (NEDS). Primary SE and secondary SE (SE in a case who visited the ED for other primary reason) were compared with non-SE seizures. Secondary SE is expected to have worse outcomes and higher costs because of another primary cause for ED visit.
In the period 2010-2014, there were 149,750 ED visits with primary SE; 83,459 ED with secondary SE; and 5,359,103 ED visits with non-SE seizures. On multivariable analysis adjusting for potential confounders, the odds of hospital admission were 7 times higher for primary SE than for non-SE seizures, and 5 times higher for secondary SE than for non-SE seizures; the odds of transfer to another hospital were 9 times higher for primary SE than for non-SE seizures, and 3 times higher for secondary SE than for non-SE seizures; the odds of death were 2.5 times higher for primary SE than for non-SE seizures, and 12 times higher for secondary SE than for non-SE seizures; and the charges (in January 2020 USA dollars) were $9000 higher in primary SE than in non-SE seizures, and $35,000 higher in secondary SE than in non-SE seizures.
Among all reasons for ED visits, SE, and in particular, secondary SE, are among the most resource-consuming conditions, being much more expensive than non-SE seizures in the ED.
描述急诊科（ED）癫痫持续状态（SE）的流行病学和卫生资源利用情况。
回顾性描述性研究在全国急诊部样本（NEDS）中进行。将原发性 SE 和继发性 SE（在因其他原发性原因就诊于 ED 的病例中出现的 SE）与非 SE 发作进行比较。继发性 SE 由于 ED 就诊的另一个主要原因，预计结局更差，费用更高。
在 2010-2014 年期间，有 149750 例 ED 就诊原发性 SE；83459 例 ED 就诊继发性 SE；5359103 例 ED 就诊非 SE 发作。在调整潜在混杂因素的多变量分析中，原发性 SE 入院的可能性是非 SE 发作的 7 倍，继发性 SE 入院的可能性是非 SE 发作的 5 倍；原发性 SE 转院的可能性是非 SE 发作的 9 倍，继发性 SE 转院的可能性是非 SE 发作的 3 倍；原发性 SE 死亡的可能性是非 SE 发作的 2.5 倍，继发性 SE 死亡的可能性是非 SE 发作的 12 倍；费用（2020 年 1 月美国美元）原发性 SE 比非 SE 发作高出 9000 美元，继发性 SE 比非 SE 发作高出 35000 美元。
在所有 ED 就诊原因中，SE，尤其是继发性 SE，是消耗资源最多的疾病之一，在 ED 中非 SE 发作的费用要高得多。
