Emergency department management of patients with seizures: A multicenter study
Emergency department management of patients with seizures: A multicenter study
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DOI：
10.1111/j.1553-2712.2001.tb00175.x
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发表时间：
2001-06-01
影响因子：
4.4
通讯作者：
Gibbs, MA
中科院分区：
文献类型：
--
作者：
Huff, JS;Morris, DL;Gibbs, MA
目的：癫痫患者在急诊科（艾德）很常见，但对这些患者的管理知之甚少。本研究旨在确定艾德患者人群中癫痫发作疾病患者的频率，并确定可能的癫痫发作病因、诊断活动特征、治疗和处置。研究方法：1997年底，12名ED监测了所有主诉与癫痫发作相关的患者，主诉时间超过18.25天（占全年的5%）。回顾性病历审查用于收集这些连续病例的具体数据。结果：在研究期间接受这12个ED治疗的31，508例患者中，368例（1.2%）有癫痫发作相关投诉。362张图表可用于分析，并构成研究人群。二百五十七（71%）利用紧急医疗服务（EMS）的运输和护理。304例（84%）患者接受了高级护理，包括静脉通路、实验室工作、心脏监测或输氧。199例（55%）患者接受抗癫痫药物治疗。177例（49%）患者的酒精戒断或抗癫痫药物水平低是影响因素。94例（26%）患者被认为存在新发癫痫发作。仅21例（6%）患者发生癫痫持续状态。所有患者中有98例（27%）住院。结论：在艾德人群中，癫痫发作相关主诉的患者很常见，对EMS和艾德资源的需求相当大。6%的癫痫相关表现的患者处于癫痫持续状态，超过四分之一的患者需要住院治疗。
Objectives: Patients with seizure disorders are common in the emergency department (ED) yet little is known regarding the management of these patients. This study was performed to define the frequency of patients with seizure disorders in the ED patient population and to determine possible seizure etiologies, characteristics of diagnostic activities, treatments, and dispositions. Methods: Twelve EDs monitored all patients with a chief complaint related to seizure disorders presenting over 18.25 days (5% of the calender year) in late 1997. Retrospective chart review was used to gather specific data regarding these consecutive cases. Results: Of the 31,508 patients who presented to these 12 EDs during the study period, 368 (1.2%) had complaints related to seizures. Three hundred sixty-two charts were available for analysis and make up the study population. Two hundred fifty-seven (71%) utilized emergency medical services (EMS) for transport and care. Advanced care, including intravenous access, laboratory work, cardiac monitoring, or oxygen administration, was utilized in 304 (84%) patients. Antiepileptic drugs were given in 199 (55%) patients. Ethanol withdrawal or low antiepileptic drug levels were implicated as contributing factors in 177 (49%) of patients. New-onset seizures were thought to be present in 94 (26%) patients. Status epilepticus occurred in only 21 (6%) patients. Ninety-eight (27%) of all patients were admitted to the hospital. Conclusions: Patients with presenting complaints related to seizures are frequent in the ED population and make considerable demands on EMS and ED resources. Six percent of patients with seizure-related presentations were in status epilepticus and more than a fourth of all patients required hospitalization.