Title

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

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