Department of Neurology, Children's Hospital of Richmond, VCU Health System, Richmond, VA, USA.
Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
Eur J Pediatr. 2022 Jun;181(6):2201-2213. doi: 10.1007/s00431-022-04431-w. Epub 2022 Mar 16.
The baseline risk for multiple febrile seizures within the same febrile illness is largely unknown. Estimates range from 5 to 30%. Imprecise estimates can lead to incorrectly powering studies investigating the management of febrile seizures. To estimate the risk of multiple febrile seizures in the same febrile illness, we systematically reviewed and conducted a meta-analysis of studies from January 2000 to December 2021 that contained data for the number of children for both simple and complex febrile seizures in the same febrile illness. We searched MEDLINE, EMBASE, and Web of Science for randomized, quasi-randomized, prospective, and retrospective trials that involved children with febrile seizures. A total of 23,131 febrile illnesses with febrile seizures met the inclusion criteria. The estimated baseline risk of multiple febrile seizures in the same febrile illness was 17% (95% CI, 16-19%). However, the 30 cohorts that included both admitted and non-admitted patients had a lower percentage of multiple FSs within the same illness (14%; 95% CI, 12-15%) than the 30 cohorts that enrolled only admitted patients (20%; 95% CI, 16-25%).
Researchers can use estimates in this paper to design future studies. Taking into the account the substantial heterogeneity between countries and studies, clinicians could cautiously use our estimates in their clinical assessment and be better able to set parental expectations about a child's chances of having another febrile seizure during the current illness.
PROSPERO CRD42020191784. Registered July 18, 2020.
• There is renewed interest in the diagnostic workup and prophylactic treatment of febrile seizures to prevent repeat seizures in the same febrile illness. • There is a lack of accurate estimates of the baseline risk for multiple febrile seizures in the same illness to properly design studies investigating management.
• This study provides the most robust estimates for the baseline risk for multiple febrile seizures in the same illness.
单次热性惊厥（FS）后短期内再次发生 FS 的风险尚不明确，范围为 5%~30%。既往研究中，由于估计值不够准确，导致针对 FS 管理的研究效能不足。本研究旨在通过系统评价和荟萃分析，为评估同一发热性疾病中多次 FS 风险提供可靠的依据。
本研究检索了 2000 年 1 月至 2021 年 12 月间发表的相关文献，纳入包含同一发热性疾病中单纯性 FS 和复杂性 FS 例数的前瞻性和回顾性研究。采用随机效应模型计算比值比（OR）及其 95%可信区间（CI）。
共纳入 23131 例发热性疾病患儿，其中 17%（95%CI，16%19%）发生了多次 FS。但纳入住院和非住院患儿的 30 项研究中，同一疾病中多次 FS 的比例（14%，95%CI，12%15%）较仅纳入住院患儿的研究（20%，95%CI，16%~25%）更低。
本研究为评估同一发热性疾病中多次 FS 风险提供了参考依据，也为 FS 管理相关研究的设计提供了依据。
