Abstracts

Rationale: 1) To determine the financial cost for patients presenting to the emergency department with febrile seizures, complex febrile seizures, new onset seizures and recurrent seizures. 2) To determine the length of stay (LOS) in the Emergency Department of these patients. Methods: All patients between the ages of the 0-18 years of age presenting to the Emergency Department in Le Bonheur Children s Hospital with simple febrile seizures, complex febrile seizures, new onset seizure and recurrent seizures not requiring hospital admission were included in this retrospective chart review for the month of January of 2008. Transportation charges, physician charges, laboratory charges, and facility charges were assessed for each patient. We were unable to obtain Radiology physician, drug levels, and medication charges, so these were not included. Results: Of the 126 charts reviewed, 101 were eligible and included in the study. Twenty-five patient charts were excluded from analysis because two patients had non-epileptic seizures, five patients were diagnosed with seizure-like activity , two charts were missing physician notes, and 16 patients had an underlying seizure disorder but were being evaluated for another medical problem not associated with their seizure disorder. LOS for new onset simple febrile seizures versus recurrent simple febrile seizures is significantly longer with new onset febrile seizures requiring more time to evaluate (p=0.04 (95% CI 2-110 mins)) with an average difference of 56 minutes. Conclusions: Children presenting to the Emergency Department with seizures can generate significant healthcare costs. Seizures are frightening for the observer but are generally short and not harmful to the patient. Healthcare costs could potentially be reduced with seizure education, home medication for emergency use, and improved access to emergency advice. In addition, visitation to the ER could be avoided resulting in less impact on the family and the ER. This is particularly pertinent for patients with recurrent seizures. Further evaluation with an active intervention in a prospective study is required.