Epilepsia Helsinki, European Reference Network EpiCARE, Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Department of Emergency Medicine and Services, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Eur J Neurol. 2023 Aug;30(8):2197-2205. doi: 10.1111/ene.15800. Epub 2023 Apr 7.
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.
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.
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.
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.
急性癫痫发作患者在急诊神经科中构成了一个庞大的患者群体。本研究旨在确定在急诊护理的不同阶段因疑似癫痫发作而导致的负担。
本研究是一项回顾性、横断面、基于人群（>100 万居民）的、为期 4 年（2015-2018 年）的研究，在一个设有单一调度中心、大学附属医院急救医疗服务（EMS）和五家急诊部（ED）的城市环境中进行。该研究涵盖了因疑似癫痫发作而从 EMS 和 ED 接受医疗护理以及在赫尔辛基大都市区住院的所有成年（≥16 岁）急诊神经科患者。
EMS 呼叫中怀疑有癫痫发作 14364 次，占研究期间所有 EMS 呼叫的 3.3%。由于疑似癫痫发作，9112 例（63.4%）病例被送往医院，3368 例（23.4%）在现场出院。6969 名患者有 11493 次与癫痫发作相关的 ED 就诊，占神经科和内科相关 ED 就诊的 3.1%，需要 4607 次住院治疗，中位住院时间为 3 天（IQR=4，范围 1-138）。在所有阶段都可以看到男性占主导地位（EMS 64.7%，EDs 60.1%，住院治疗 56.2%）。与癫痫发作相关的 EMS 呼叫的总发生率为 333/100000 居民/年，ED 就诊的发生率为 266/100000 居民/年，住院治疗的发生率为 107/100000 居民/年。总估计费用为每年 680 万欧元，占研究区域内所有专科医疗保健费用的 0.5%。
疑似癫痫发作患者给医疗保健系统带来了重大负担。当前的流行病学数据对于规划急诊服务中的资源分配至关重要。
