Care in Europe after presenting to the emergency department with a seizure; position paper and insights from the European Audit of Seizure Management in Hospitals. (7th May 2022)

• Record Type: Journal Article
• Authors: Taylor, Claire; Tudur‐Smith, Catrin; Dixon, Pete; Linehan, Christine; Gunko, Aleksei; Christensen, Jakob; Pearson, Mike; Tomson, Torbjorn; Marson, Anthony
• Other Names: Trinka Eugen investigator.; Visee Helene investigator.; Depondt Chantal investigator.; Santos Susana Ferrao investigator.; Van Dycke Annelies investigator.; Van Paesschen Wim investigator.; Conway Cara investigator.; O'Rourke Geraldine investigator.; Flynn Cora investigator.; McCarthy Allan investigator.; Cunningham Denise investigator.; Wakai Abel investigator.; Petricevic Masha investigator.; Costello Daniel investigator.; Zelano Johan investigator.; Al‐Jasami Firal investigator.; Melin Sara investigator.; Berglund Mans investigator.; Bergstrom Lisa investigator.; Vall Victor investigator.; Rouhl Rob investigator.; Dingli Nicola investigator.; Rheims Sylvain investigator.; Tazarourte Karim investigator.; Tyvaert Louise investigator.; Derambure Phillipe investigator.; Girot Marie investigator.; Marchal Cecile investigator.; Kolstad Eivind investigator.; Jahr Silje Holt investigator.; Bo Siri Hylleraas investigator.; Samsonsen Christian investigator.; Kalvianen Reetta investigator.; Mazurkiewicz‐Beldzinska Maria investigator.; Kaymovskiy Igor investigator.; Ryvlin Phillipe investigator.; Wisiewski Ilona investigator.; Bader Celia investigator.; Podewils Felix von investigator.; Knake Susanne investigator.; Menzler Katja investigator.; Hirsch Martin investigator.; Brich Jochen investigator.; Surges Rainer investigator.; Dague Karmele Olaciregui investigator.; Wehner Tim investigator.; Strzelczyk Adam investigator.; Kay Lara investigator.; Miklic Lea investigator.; Kimikidis Vasilios investigator.; Spilioti Martha investigator.; Afrantou Theodora investigator.; Terzoudi Aikaterina investigator.; Kazis Dimitrios investigator.; Markoula Sofia investigator.; Markou Katerina investigator.; Papacostas Savvas investigator.; Christou Yiolanda Panayiota investigator.;
• Is Part Of: European journal of neurology. Volume 29:Number 7(2022)
• Page Start: 1873
• Page End: 1884
• Publication Date: 2022-05-07
• Subjects: audit -- epilepsy -- neurological disorders -- quality improvement -- service evaluation; Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; 616.8
• DOI: 10.1111/ene.15336
• Languages: English
• ISSNs: 1351-5101

Abstract

Abstract: Background and purpose: This position paper makes recommendations following an audit of care provided to people presenting with a seizure to emergency departments (EDs) in Europe. Methods: Participating countries were asked to include five hospitals agreeing to identify 50 consecutive seizure patients presenting to their ED between 1 August 2016 and 31 August 2017. Anonymous data were collected to a web database. Where quoted, percentages are mean site values and ranges are the 10th–90th centile. Results: Data were collected on 2204 ED visits (47 sites, up to six per country, across 15 countries): 1270 (58%) known epilepsy, 299 (14%) previous blackouts but no epilepsy diagnosis, 634 (29%) with a first seizure. Wide variability was identified for most variables. Of those with known epilepsy, 41.2% (range 26.2%–59.6%) attended the ED in the previous 12 months, but only 64.7% (range 37.2%–79.8%) had seen an epilepsy specialist in the previous 12 months. 67.7% (range 34.0%–100%) were admitted, 53.1% to a neurology ward (range 0.0%–88.9%). Only 37.5% first seizure patients (range 0.0%–71.4%) were given advice about driving. Conclusions and recommendations: It is recommended that in Europe guidance is agreed on the management and onward referral of those presenting to the ED with a seizure; a referral process is created that can be easily implemented; it is ensured that the seizure services receive referrals and see the patients within a short time period; and a simple system is developed and implemented to allow continuous monitoring of key indices of epilepsy care. Abstract : The European Audit of Seizure Management in Hospitals (EuroNASH) shows that there is considerable and unacceptable variability in the quality of care provided to people presenting to emergency departments with a seizure in Europe. In this position paper it is recommended that in Europe (1) guidance is created and agreed for specialist referral; (2) a process for referral is created that is easy to do and can be incorporated into the workings of local hospitals with minimal effort; (3) it is ensured that the epilepsy/seizure service receives these referrals and sees the patients within a short time period; (4) a simple system is developed and implemented to allow continuous monitoring of key indices of epilepsy care.