Ortiz-Guerrero Gloria, Logan Maggie, Uysal Utku, Landazuri Patrick, Jackson Lakeshia, Ulloa Carol M
Department of Neurology, The University of Kansas Medical Center, Kansas City, Kansas, United States of America.
PLoS One. 2025 Sep 10;20(9):e0331908. doi: 10.1371/journal.pone.0331908. eCollection 2025.
The potential for racial disparity using urine drug screening (UDS) in patients with seizures is sparsely reported. This study aims to determine racial and ethnic disparities when ordering UDS in patients with suspected seizures in the emergency department (ED).
In this retrospective study, we identified patients over the age of 18 with suspected seizures who presented to the ED at the University of Kansas Medical Center between October 2017 and October 2020. Data encompassed demographic, clinical, electrographic, and UDS information from the electronic medical records (EMR). Data were compared between Black and White patients, as well as between Hispanic and non-Hispanic patients. We used the Chi-square test to assess differences in UDS testing based on patient race and ethnicity.
A total of 2945 patients were identified. Among these, 1750 (59%) were White and 821 (28%) were Black patients. Of these patients, 612 (20.8%) underwent UDS in the ED. Black patients had UDS performed more frequently compared to White patients (p = 0.046). Additionally, the positivity rate for UDS was higher among Black patients than White patients (p = 0.019). UDS testing did not differ by ethnicity (p = 0.164). Amphetamine positivity was higher among White patients; however, the positivity rates of other drugs did not differ by race and ethnicity. Black patients were more often admitted to the neurology intensive care unit. No differences in discharge rates or EEG testing were noted across race or ethnicity.
Increased UDS testing was seen in Black patients compared to White patients in our single-institution cohort, warranting further research into the underlying causes of this disparity.
关于癫痫患者使用尿液药物筛查（UDS）时存在种族差异的可能性，相关报道较少。本研究旨在确定急诊科（ED）疑似癫痫患者进行UDS检测时的种族和民族差异。
在这项回顾性研究中，我们确定了2017年10月至2020年10月期间在堪萨斯大学医学中心急诊科就诊的18岁以上疑似癫痫患者。数据包括电子病历（EMR）中的人口统计学、临床、脑电图和UDS信息。对黑人和白人患者以及西班牙裔和非西班牙裔患者的数据进行了比较。我们使用卡方检验来评估基于患者种族和民族的UDS检测差异。
共确定了2945例患者。其中，1750例（59%）为白人，821例（28%）为黑人患者。在这些患者中，612例（20.8%）在急诊科接受了UDS检测。与白人患者相比，黑人患者进行UDS检测的频率更高（p = 0.046）。此外，黑人患者的UDS阳性率高于白人患者（p = 0.019）。UDS检测在不同民族之间没有差异（p = 0.164）。白人患者的苯丙胺阳性率较高；然而，其他药物的阳性率在种族和民族之间没有差异。黑人患者更常被收入神经科重症监护病房。在种族或民族之间，出院率或脑电图检测没有差异。
在我们的单机构队列中，与白人患者相比，黑人患者的UDS检测增加，这需要对这种差异的潜在原因进行进一步研究。
