Rapid Emergency Transport and Care Reduce the Risk of Acute Encephalopathy in Children with Febrile Status Epilepticus
Abstract number :
1.127
Submission category :
13. Health Services (Delivery of Care, Access to Care, Health Care Models)
Year :
2024
Submission ID :
1304
Source :
www.aesnet.org
Presentation date :
12/7/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Tohru Okanishi, MD, PhD – Tottori University
Yuto Arai, MD – Tottori University
Sotaro Kanai, MD, PhD – Tottori University, Faculty of Medicine
Yoshihiro Maegaki, MD, PhD – Tottori University, Faculty of Medicine
Rationale: Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) frequently occurs in children with febrile status epilepticus (FSE) and often results in neurological sequelae. To date, no studies have examined the relationship between rapidity of emergency transport, emergency care and the development of AESD.
Methods: We conducted a retrospective study of children with FSE (seizures lasting more than 30 minutes) who were treated at Tottori University Hospital. We analyzed data on prehospital emergency care to investigate its association with the development of AESD.
Results: The study included 11 patients who developed AESD and 44 patients with FSE. We found that the time from seizure onset to the arrival of emergency medical services (EMS) (OR: 1.12, P = 0.015) and to hospital arrival (OR: 1.07, P = 0.009) was positively associated with the development of AESD. Conversely, higher oxygen saturation levels in ambulances (OR: 0.901, P = 0.013) were negatively associated with AESD development. Additionally, the time from seizure onset to hospital arrival was closely linked to the time from onset to the administration of antiseizure medications (ASMs) (correlation coefficient: 0.857, P < 0.001), which was significantly associated with AESD development (OR: 1.04, P = 0.039). The critical cutoff times identified were 17 minutes from onset to EMS arrival (OR: 27.2, P = 0.003), 38 minutes to hospital arrival (OR: 5.71, P = 0.020), and 50 minutes to ASM administration (OR: 7.11, P = 0.009).
Conclusions: Delayed time from seizure onset to hospital arrival and hypoxia during ambulance transport were linked to the development of AESD. Reducing transport time, enhancing respiratory management in ambulances, and administering ASMs earlier could help prevent the development of AESD.
Funding: Grant-in-Aid for Scientific Research (KAKENHI) (Type C, Grant number: 21K07751) from the Japan Society for the Promotion of Science
Health Services (Delivery of Care, Access to Care, Health Care Models)