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Many hospitals see pediatric patients who present with seizures in the emergency department, but a majority of cases that require admission are transferred to other facilities.
A seizure is a scary experience for parents and children, most often leading to a trip the emergency department (ED). A new study in JAMA Network Open examines what happens to children when they need to be admitted for further care.1
Investigators used inpatient and ED administrative data sets from all acute care hospitals in 2014 in Arkansas, Florida, Kentucky, Maryland, Massachusetts, and New York. They included all patients aged younger than 18 years who visited the hospital and had a primary diagnosis of seizures. There were a total of 57,930 visits in 621 hospitals for pediatric patients with seizures, with a median age of 4 years and 55.2% involved boys.
Among the 57,930 visits, 15,467 were admitted to inpatient care and 3748 were transferred to another acute care hospital. Among the encounters that involved transfer, seizure was the only diagnosis for 1554 patients. A sizeable number of the encounters, 42,463, started as ED visits and 38,173 ended in routine discharge. Although 86.3% of hospitals transferred children with seizures, 37.4% of hospitals ever admitted patients with seizure and only 10.1% ever received a pediatric seizure transfer. Patients who were admitted had brief stays and no comorbidities. Roughly 77% of all admissions were for hospitals with a pediatric Hospital Capability Index Score greater than 0.75.
Researchers concluded that most hospitals transfer pediatric patients with seizures who required inpatient services. This dependency on other hospitals should be considered for emergency medical service planning, access to care policies, and health services
FranÃ§a U, McManus ML. Assessment of acute hospital use and transfers for management of pediatric seizures. JAMA Netw Open. 2020;3(4):e203148. doi: 10.1001/jamanetworkopen.2020.3148