Cargando…
Race and the emergency department management of febrile seizures
To determine if racial disparities exist in the management of febrile seizures in a large pediatric emergency department (ED), We performed a retrospective cross-sectional analysis of children 6 months to 6 years-old who presented to the ED with a febrile seizure over a 4-year period. Multivariate l...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9592322/ https://www.ncbi.nlm.nih.gov/pubmed/36281195 http://dx.doi.org/10.1097/MD.0000000000031315 |
_version_ | 1784814898720538624 |
---|---|
author | Chang, Gina Blackstone, Mercedes McGuire, Jennifer L |
author_facet | Chang, Gina Blackstone, Mercedes McGuire, Jennifer L |
author_sort | Chang, Gina |
collection | PubMed |
description | To determine if racial disparities exist in the management of febrile seizures in a large pediatric emergency department (ED), We performed a retrospective cross-sectional analysis of children 6 months to 6 years-old who presented to the ED with a febrile seizure over a 4-year period. Multivariate logistic regression models were built to examine the association between race and the primary outcome of neuroimaging, and secondary outcomes of hospital admission and abortive anticonvulsant prescription at ED discharge. There were 980 ED visits during the study period. Overall, 4.0% of children underwent neuroimaging and 11.1% were admitted. Of the 871 children discharged from the ED, 9.4% were prescribed an abortive anticonvulsant. There were no differences by race in neuroimaging or hospital admission. However, black children were less likely to be prescribed abortive anticonvulsants (adjusted odds ratio [aOR] 0.47; 95% confidence interval [CI]: 0.23–0.96) compared to non-black peers, when adjusting for demographic and clinical confounders. Stratification by insurance revealed that this disparity existed in Medicaid-insured patients (aOR 0.33, 95% CI: 0.14–0.78) but not in privately-insured patients. We found no racial disparities in neuroimaging or hospital admission among ED patients with febrile seizures. We did find racial disparities in our secondary outcome of abortive anticonvulsant prescription, driven primarily by individuals on Medicaid insurance. This pattern of findings may reflect the lack of standardized recommendations regarding anticonvulsant prescription, in contrast to the guidelines issued for other ED management decisions. Further investigation into the potential for treatment guidelines to reduce racial disparities is needed. |
format | Online Article Text |
id | pubmed-9592322 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-95923222022-10-25 Race and the emergency department management of febrile seizures Chang, Gina Blackstone, Mercedes McGuire, Jennifer L Medicine (Baltimore) 6200 To determine if racial disparities exist in the management of febrile seizures in a large pediatric emergency department (ED), We performed a retrospective cross-sectional analysis of children 6 months to 6 years-old who presented to the ED with a febrile seizure over a 4-year period. Multivariate logistic regression models were built to examine the association between race and the primary outcome of neuroimaging, and secondary outcomes of hospital admission and abortive anticonvulsant prescription at ED discharge. There were 980 ED visits during the study period. Overall, 4.0% of children underwent neuroimaging and 11.1% were admitted. Of the 871 children discharged from the ED, 9.4% were prescribed an abortive anticonvulsant. There were no differences by race in neuroimaging or hospital admission. However, black children were less likely to be prescribed abortive anticonvulsants (adjusted odds ratio [aOR] 0.47; 95% confidence interval [CI]: 0.23–0.96) compared to non-black peers, when adjusting for demographic and clinical confounders. Stratification by insurance revealed that this disparity existed in Medicaid-insured patients (aOR 0.33, 95% CI: 0.14–0.78) but not in privately-insured patients. We found no racial disparities in neuroimaging or hospital admission among ED patients with febrile seizures. We did find racial disparities in our secondary outcome of abortive anticonvulsant prescription, driven primarily by individuals on Medicaid insurance. This pattern of findings may reflect the lack of standardized recommendations regarding anticonvulsant prescription, in contrast to the guidelines issued for other ED management decisions. Further investigation into the potential for treatment guidelines to reduce racial disparities is needed. Lippincott Williams & Wilkins 2022-10-21 /pmc/articles/PMC9592322/ /pubmed/36281195 http://dx.doi.org/10.1097/MD.0000000000031315 Text en Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC) (https://creativecommons.org/licenses/by-nc/4.0/) , where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. |
spellingShingle | 6200 Chang, Gina Blackstone, Mercedes McGuire, Jennifer L Race and the emergency department management of febrile seizures |
title | Race and the emergency department management of febrile seizures |
title_full | Race and the emergency department management of febrile seizures |
title_fullStr | Race and the emergency department management of febrile seizures |
title_full_unstemmed | Race and the emergency department management of febrile seizures |
title_short | Race and the emergency department management of febrile seizures |
title_sort | race and the emergency department management of febrile seizures |
topic | 6200 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9592322/ https://www.ncbi.nlm.nih.gov/pubmed/36281195 http://dx.doi.org/10.1097/MD.0000000000031315 |
work_keys_str_mv | AT changgina raceandtheemergencydepartmentmanagementoffebrileseizures AT blackstonemercedes raceandtheemergencydepartmentmanagementoffebrileseizures AT mcguirejenniferl raceandtheemergencydepartmentmanagementoffebrileseizures |