% 0期刊文章%艾米丽·k·阿克顿%一个利亚j .空白%艾莉森•威利斯(george w . bush) %阿里·g·Hamedani % T Interfacility转移Seizure-Related突发事件在美国% D R 10.1212 / WNL 2022%。0000000000201319 % J首页神经病学% P e2718-e2727 % V 99% N 24% X背景和目标Interfacility转让协议对seizure-related突发事件很重要,原因大约1%的急诊(ED)访问在美国,但数据对当前实践缺乏。我们评估了流行、时间趋势和模式interfacility seizure-related ED访问后转移。方法我们进行回顾性纵向横向分析的ED性情seizure-related紧急成人和儿科人群使用全国急诊样本(他们)。我们使用回归分析年度趋势的连接点ED访问和转移率从2007年到2018年。逻辑回归模型使用数据从2016年到2018年探索病人——和管理员转移和入学的相关因素。抽样权重被应用于解释复杂的调查他们的设计。结果使用全国代表性数据从2007年到2018年,有7372065加权ED访问seizure-related突发事件,其中包括419368(5.6%)访问的初步诊断癫痫持续状态。我们发现2.3% - -5.6%的所有这些seizure-related ED访问导致了interfacility转移,转移率显著增加。在ED访问专门为癫痫持续状态、interfacility转移导致19.8%到23.24%的访问,也会随着时间的推移而增加。 Multivariable logistic regression of adult and pediatric visits for status epilepticus revealed that transferring hospitals were more likely to be nonmetropolitan (adjusted odds ratio [aOR] 2.2, 95% CI 1.6–2.9) and less likely to have continuous electroencephalography (cEEG) capabilities (aOR 0.3, 98% CI 0.3–0.4). Transferred patients were more likely to be children (aOR 1.5, 95% CI 1.3–1.6 for those 1–4 years old; aOR 1.5 (95% CI 1.3–1.7) for ages 5–14 years), have acute cerebrovascular disease (aOR 1.4, 95% CI 1.1–1.8), and have received mechanical ventilation (aOR 1.5, 95% CI 1.4–1.7).Discussion By 2018, approximately 1 in 19 seizure-related and 1 in 5 status epilepticus ED visits resulted in interfacility transfers. In order of strength of association, illness severity, ED seizure volume, comorbid meningitis and traumatic brain injury, nonrural location, cEEG capabilities, and pediatric age favored admission. Rural location, lack of cEEG capabilities, and comorbid stroke favored transfer. Thoughtful deployment of novel EEG technologies and teleneurology tools may help optimize triage and prevent unnecessary ED transfers.AHRQ=Agency for Healthcare Research and Quality; cEEG=continuous electroencephalography; CPT=Current Procedural Terminology; ED=emergency department; ICD-9-CM=International Classification of Diseases, Ninth Revision, Clinical Modification; NEDS=Nationwide Emergency Department Sample; OR=odds ratio; TBI=traumatic brain injury %U //www.ez-admanager.com/content/neurology/99/24/e2718.full.pdf