Characteristics and Risk Factors of Seizure-related Injuries in Patients Presenting with Seizures to the Emergency Room

Abstract

Background: The goal of this study was to investigate the incidence and type of seizurerelated injuries (SRIs) in patients presenting with seizures to the emergency department (ED) and to determine the risk factors of SRIs.Methods: In this retrospective cross-sectional study, we surveyed all seizure patients aged 18 years and older who visited the ED of Yeungnam University Hospital between October 2017 and September 2019. We excluded patients who developed seizures secondary to cardiac arrest or acute head trauma.Results: A total of 165 patients were enrolled and SRIs occurred in 33 patients (20.0%). The most common SRI was head injury (35.3%), followed by soft tissue injury (29.4%) and orolingual injury (17.6%). Most injuries were single, minor injury and required little or no treatment. Death occurred in one patient (3.0%) with SRIs due to intracranial hemorrhage. On univariate analysis, young age (<i>p</i><0.001), history of alcohol use disorder (<i>p</i>=0.005), hypertension (<i>p</i>=0.022) and stroke (<i>p</i>=0.032), falling during seizure (<i>p</i><0.001), seizure cluster (<i>p</i>=0.001), convulsive status epilepticus (<i>p</i>=0.034), generalized tonic-clonic seizure (<i>p</i>=0.010), initial blood ammonia level (<i>p</i>=0.007), and alcohol-related seizure (<i>p</i>=0.032) predicted the occurrence of SRIs. All patients with SRIs were independent in daily activities. On multiple logistic regression analysis, five variables remained significant: young age (<i>p</i>=0.037), history of alcohol use disorder (<i>p</i>=0.040), falling during seizure (<i>p</i><0.001), seizure cluster (<i>p</i>=0.013), and convulsive status epilepticus (<i>p</i>=0.032).Conclusions: Young age, history of alcohol use disorder, falling during seizure, seizure cluster, and convulsive status epilepticus predicted SRIs in people presenting with seizure.