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• W3215537754 abstract "Seizures are a frequent reason for admission to emergency departments and require early, precise diagnosis and treatment. The objective of this study was to describe the clinical and prognostic characteristics of a series of patients with seizures attended at our hospital’s emergency department. We performed a retrospective, observational study of all patients with seizures who were admitted to our hospital’s emergency department and attended by the on-call neurology service between February and August 2017. We included 153 patients, representing 9.9% of all neurological emergency department admissions. The median age was 58 years, 52.3% of patients were women, and 51% had history of epilepsy. Onset was focal in 82.4% of cases, and the most frequent aetiology was cerebrovascular disease (24.2%). Twelve patients (7.8%) developed status epilepticus, which was associated with higher scores on the ADAN scale (P < .001) and with history of refractory epilepsy (P = .002). The in-hospital mortality rate was 3.7%, and in-hospital mortality was associated with older age (P = .049) and status epilepticus (P = .018). Eighty percent of patients with no history of epilepsy were diagnosed with epilepsy at the emergency department; all started treatment. The kappa coefficient for epilepsy diagnosis in the emergency department compared to diagnosis after one year of follow-up by the epilepsy unit was 0.45 (diagnosis was modified in 20% of patients). Seizures are a frequent neurological emergency with potential complications and considerable morbidity and mortality rates. In patients with no known history of epilepsy, the condition may be diagnosed in the emergency department, but follow-up at specialised epilepsy units is recommended. Las crisis epilépticas son un motivo de ingreso frecuente en urgencias y requieren una actuación diagnóstico-terapéutica precoz y precisa. Nuestro objetivo fue describir las características clínico-evolutivas de una serie de pacientes con crisis epilépticas atendidos en Urgencias. Estudio observacional retrospectivo de todos los pacientes con crisis epilépticas que ingresaron en Urgencias y fueron atendidos por neurología de guardia, de febrero a agosto de 2017. Se incluyeron 153 pacientes, correspondientes al 9,9% del total de urgencias neurológicas. La mediana de edad fue 58 años, el 52,3% fueron mujeres, y el 51% tenía antecedente de epilepsia. El 82,4% de las crisis tuvo un inicio focal y la etiología más frecuente fue la patología cerebrovascular (24,2%). Doce pacientes se complicaron con estatus epiléptico (7,8%), lo que se relacionó con mayor puntuación en la escala ADAN (p < 0,001) y con antecedente de epilepsia refractaria (p = 0,002). La mortalidad hospitalaria fue del 3,7%; se asoció a mayor edad (p = 0,049) y a estatus epiléptico (p = 0,018). El 80% de los pacientes sin epilepsia conocida recibió el diagnóstico de epilepsia en Urgencias, todos iniciaron tratamiento. El índice kappa de concordancia para el diagnóstico de epilepsia en Urgencias comparado con el diagnóstico tras un año de seguimiento en la Unidad de epilepsia fue 0,45 (se modificó el diagnóstico en el 20% de los pacientes). Las crisis epilépticas constituyen una urgencia neurológica frecuente, con potenciales complicaciones y una morbimortalidad relevante. En pacientes sin epilepsia conocida, es apropiado realizar el diagnóstico de epilepsia en urgencias, pero es recomendable un seguimiento posterior en consultas especializadas." @default.
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• W3215537754 date "2023-01-01" @default.
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• W3215537754 title "Seizures in the Emergency Department: clinical and diagnostic data from a series of 153 patients" @default.
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• W3215537754 doi "https://doi.org/10.1016/j.nrleng.2020.02.011" @default.
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