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Abstract Details

The Effects of Psychiatric Co-Morbidity on Recurrent Emergency Department (ED) Visits in Patients with Epileptic Seizures – Experience from a Single County Hospital
Epilepsy/Clinical Neurophysiology (EEG)
Epilepsy/Clinical Neurophysiology (EEG) Posters (7:00 AM-5:00 PM)
124
Objectives of this study were to a) assess predictors for recurrent emergency department (ED) visits for seizures and b) analyze the impact of coexisting psychiatric disorders on clinical management and ED visit recurrence among seizure patients.
Seizures represent over 1 million visits to U.S. emergency departments annually, utilizing a sizeable portion of healthcare resources. Still, literature regarding which factors may predict ED visit recurrence in order to optimize disease control and resource utilization are lacking.  Additionally, despite the prevalence of psychiatric disorders among seizure patients and the well-studied notion that psychiatric comorbidity can contribute to poorer clinical outcome variables, studies analyzing differences in follow-up or clinical decision-making among seizure patients with neuropsychiatric comorbidities are few.
This was a retrospective study. EMR inquiry was performed for adults age >18 years presenting to the ED of Parkland Memorial Hospital in Dallas, Texas between 2019 and 2020 with a primary diagnosis of seizure. Demographics, prior seizure and neuropsychiatric diagnoses, antiseizure medication noncompliance, clinical workup and follow-up variables, and ED visit recurrence were collected.
Of 206 patients meeting inclusion criteria, 100 (48.5%) had an underlying psychiatric diagnosis. Of these, 31 patients (31.0%) had a recurrent ED visit for seizure compared to 20 out of the 106 (18.8%) without a psychiatric disorder (p=0.044). With regard to follow-up, 70 of 95 (73.7%) patients with psychiatric comorbidities had follow-up scheduled compared to 83 of 95 (87.4%) in the non-psychiatric group (p=0.017). In subgroup analysis controlling for disease severity, only 6 of 26 psychiatric patients (23.1%) attended their follow-up versus 17 of 32 (53.1%) in the non-psychiatric group (p=0.020).
Our findings suggest that psychiatric co-morbidity was associated with higher ED visit recurrence for seizures and lower follow-up placement and attendance, illustrating the need for improving follow-up adherence and optimizing seizure control in this population.
Authors/Disclosures
Anika Morgado
PRESENTER 		Ms. Morgado has nothing to disclose.
Kan Ding, MD (UT Southwestern Medical Center) The institution of Dr. Ding has received research support from National Institute of Aging. The institution of Dr. Ding has received research support from NINDS.
Mark Agostini, MD (U.T. Southwestern Medical Center) Dr. Agostini has nothing to disclose.
Fatima Zuberi, MD, BA Fatima Zuberi has nothing to disclose.
Rodrigo Zepeda, MD (University of Texas Southwestern) The institution of Dr. Zepeda has received research support from NIH.
Ghazala Perven, MD (UT Southwestern Medical Center) Dr. Perven has nothing to disclose.
Marisara Dieppa, MD (University of Texas SW Medical School) Dr. Dieppa has nothing to disclose.
Alexander Doyle, MD (University of Texas SW Medical School) Dr. Doyle has nothing to disclose.
Ryan Hays, MD, MBA, FAES, FÂ鶹´«Ã½Ó³»­ (UT Southwestern Medical Center) Dr. Hays has nothing to disclose.
Rohit Das, MD, FÂ鶹´«Ã½Ó³»­ (VA Portland Healthcare System) Dr. Das has received personal compensation for serving as an employee of Oregon Health Science University. Dr. Das has received personal compensation in the range of $10,000-$49,999 for serving as a Physician Advisor with Concentra .
J. H. Harvey, DO (UT Southwestern Medical Center) Dr. Harvey has received personal compensation for serving as an employee of Neuralogix. Dr. Harvey has received personal compensation for serving as an employee of Integris . Dr. Harvey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jazz Pharmaceuticals. Dr. Harvey has stock in Epiminder.
Hina N. Dave, MD (Debakey VA hospital) Dr. Dave has nothing to disclose.
Sasha Alick-Lindstrom, MD, MPH FACNS, FAES, FÂ鶹´«Ã½Ó³»­ (UT Southwestern Medical Center) Dr. Alick-Lindstrom has nothing to disclose.
No disclosure on file