Establishment of achievable benchmarks of care in the neurodiagnostic evaluation of simple febrile seizures.
Document Type
Article
Publication Date
5-2022
Identifier
DOI: 10.1002/jhm.12833
Abstract
BACKGROUND: Current guidelines recommend against neurodiagnostic testing for the evaluation of simple febrile seizures.
OBJECTIVES: (1) Assess overall and institutional rates of neurodiagnostic testing and (2) establish achievable benchmarks of care (ABCs) for children evaluated for simple febrile seizures at children's hospitals.
DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional study of children 6 months to 5 years evaluated in the emergency department (ED) 2016-2019 with simple febrile seizures at 38 children's hospitals in Pediatric Health Information System database. We excluded children with epilepsy, complex febrile seizures, complex chronic conditions, and intensive care.
OUTCOME MEASURES: Proportions of children who received neuroimaging, electroencephalogram (EEG), or lumbar puncture (LP) and rates of hospitalization for study cohort and individual hospitals. Hospital-specific outcomes were adjusted for patient demographics and severity of illness. We utilized hospital-specific values for each measure to calculate ABCs.
RESULTS: We identified 51,015 encounters. Among the study cohort 821 (1.6%) children had neuroimaging, 554 (1.1%) EEG, 314 (0.6%) LP, and 2023 (4.0%) were hospitalized. Neurodiagnostic testing rates varied across hospitals: neuroimaging 0.4%-6.7%, EEG 0%-8.2%, LP 0%-12.7% in patients
CONCLUSIONS: Rates of neurodiagnostic testing and hospitalization for simple febrile seizures were low but varied across hospitals. Calculated ABCs were 0%-1% for all measures, demonstrating that adherence to current guidelines is attainable.
Journal Title
J Hosp Med
Volume
17
Issue
5
First Page
327
Last Page
341
MeSH Keywords
Benchmarking; Child; Cross-Sectional Studies; Hospitals, Pediatric; Humans; Infant; Retrospective Studies; Seizures, Febrile
Keywords
Benchmarking; Cross-Sectional Studies; Pediatric Hospitals; Retrospective Studies; Febrile Seizures
Recommended Citation
Stephens JR, Hall M, Molloy MJ, et al. Establishment of achievable benchmarks of care in the neurodiagnostic evaluation of simple febrile seizures. J Hosp Med. 2022;17(5):327-341. doi:10.1002/jhm.12833
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