We determined how often patients with epilepsy presented to the emergency department (ED) for seizure and the frequency and predictors for undergoing emergent neuroimaging during those visits. We conducted a retrospective population-based cohort study using administrative claims' data from 2007 to 2015. Adults with epilepsy were identified based on a diagnosis of epilepsy and an outpatient prescription for an antiepileptic medication. The Bonferroni corrected significance level was 0.0018. We identified 381,362 patients with a mean follow-up period of 1.99 years, of whom 35,015 (9.2%) patients presented to the ED for seizure at least once. Patients with at least one ED visit were younger, more likely to be male, had fewer comorbidities, and had longer follow-up as compared with those with no ED visit (all p < 0.001). Among the 35,015 patients presenting to the ED, 13.6% had neuroimaging, mostly commonly head computed tomography (CT; 95.5%). Patients undergoing neuroimaging were younger (46 versus 48 years) and with higher rates of psychosis (17.4% versus 13.8%) and depression (16.1% versus 12.2%; p < 0.001). This helps to quantify the burden of ED and emergent neuroimaging utilization for patients with epilepsy and can help inform efforts to curtail unnecessary neuroimaging.

中文翻译：

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癫痫发作的紧急神经影像学：一项人口研究

我们确定了癫痫患者因癫痫而到急诊科 (ED) 就诊的频率，以及在这些就诊期间接受紧急神经影像学检查的频率和预测因素。我们使用 2007 年至 2015 年的行政索赔数据进行了一项基于人群的回顾性队列研究。成人癫痫患者是根据癫痫的诊断和抗癫痫药物的门诊处方确定的。Bonferroni 校正的显着性水平为 0.0018。我们确定了 381,362 名患者，平均随访期为 1.99 年，其中 35,015 (9.2%) 名患者因癫痫发作至少一次就诊于 ED。与没有就诊的患者相比，至少就诊一次的患者更年轻，更可能是男性，合并症更少，随访时间更长（所有 p < 0.001）。在这 35 个中，015 名就诊于 ED 的患者中，13.6% 进行了神经影像学检查，主要是头部计算机断层扫描（CT；95.5%）。接受神经影像学检查的患者更年轻（46 岁与 48 岁），精神病（17.4% 与 13.8%）和抑郁症（16.1% 与 12.2%；p < 0.001）的发生率更高。这有助于量化癫痫患者 ED 和紧急神经影像学利用的负担，并有助于为减少不必要的神经影像学的努力提供信息。