Referral patterns after a seizure admission in an English region: an opportunity for effective intervention? An observational study of routine hospital data

BMJ Open
Ruth GraingerAnthony G Marson

Abstract

To identify emergency seizure admissions to hospital and their subsequent access to specialist outpatient services. Algorithmic analysis of anonymised routine hospital data over 7 years using specialist follow-up by 3 months as the target outcome. All adults resident in Merseyside and Cheshire, England. Whether, and when, access to the specialist advice that might prevent further admissions was offered. 1.4% of all emergency medical admissions are as a result of seizure. In the following 12 months 35% were readmitted and experienced a mean of 2.3 emergency department visits. Only 27% (48% of those already known to specialists and 13% of those not known) were offered appointments. Subsequent attendance at a specialist clinic is more likely if already known to a clinic, if aged <35 years, if female, or required a longer spell in hospital. Extrapolation from other work suggests 100,000 bed days per annum could be saved. Most seizure admissions are not being referred for the help that could prevent future admissions. The majority of those that are referred are not seen within an appropriate time frame. Our service structures are not providing an optimum service for people with epilepsy.

References

Nov 17, 2007·Medical Care·Vijaya SundararajanUNKNOWN International Methodology Consortium for Coded Health Information (IMECCHI)
Mar 13, 2012·QJM : Monthly Journal of the Association of Physicians·K A AbrahamM Pearson
Sep 7, 2012·Epilepsy Research and Treatment·Parameswaran M IyerColin P Doherty
Apr 26, 2013·The Canadian Journal of Hospital Pharmacy
Jun 28, 2013·BMJ : British Medical Journal·Grammati SarriUNKNOWN Guideline Development Group
Jun 20, 2015·BMJ : British Medical Journal·Paul K Morrish
Mar 25, 2016·Deutsches Ärzteblatt International·Carolin FleischmannKonrad Reinhart

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Citations

Mar 20, 2020·Clinical Medicine : Journal of the Royal College of Physicians of London·James W MitchellAnthony G Marson
Jan 16, 2021·Seizure : the Journal of the British Epilepsy Association·Gabriella WojewodkaLeone Ridsdale
Jan 29, 2021·Epilepsy & Behavior : E&B·Morgan T MazanecBarbara C Jobst
Jan 31, 2020·Seizure : the Journal of the British Epilepsy Association·Lisa BurrowsRohit Shankar

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