본문 바로가기
KERD
논문KCI 등재

동일 이환기간 내 열발작 반복의 위험인자

Risk factors for repeated febrile seizures during the same febrile illness

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류소아과학

초록

Purpose: We aimed to identify the factors associated with the repeated febrile seizures (RFS), defined as recurrent seizures during the same febrile illness. Methods: We reviewed the medical records of children with febrile seizure who visited 4 academic emergency departments from October 2016 through September 2018. Differences were identified in variables regarding clinical and laboratory characteristics between the children with and without RFS. The RFS was the primary outcome. Logistic regression was conducted to identify factors associated with the occurrence of RFS. Results: Among 1,551 children, 922 were included in the study, of whom, 198 (21.5%) underwent RFS. Of the children with RFS, 188 (94.9%) underwent the recurrences within the initial 24 hours. Logistic regression showed focal seizure (adjusted odds ratio, 6.67; 95% confidence interval, 2.37-18.82), venous pH < 7.31 (5.89; 3.13-11.08), and postictal drowsiness > 30 minutes (1.90; 1.30-2.78) as the factors for RFS. Conclusion: In children with febrile seizure, focal seizure, acidosis, and prolonged postictal state may be independent risk factors for RFS. These findings may be informed to healthcare professionals and parents caring for children with febrile seizure.

Abstract

Purpose: We aimed to identify the factors associated with the repeated febrile seizures (RFS), defined as recurrent seizures during the same febrile illness. Methods: We reviewed the medical records of children with febrile seizure who visited 4 academic emergency departments from October 2016 through September 2018. Differences were identified in variables regarding clinical and laboratory characteristics between the children with and without RFS. The RFS was the primary outcome. Logistic regression was conducted to identify factors associated with the occurrence of RFS. Results: Among 1,551 children, 922 were included in the study, of whom, 198 (21.5%) underwent RFS. Of the children with RFS, 188 (94.9%) underwent the recurrences within the initial 24 hours. Logistic regression showed focal seizure (adjusted odds ratio, 6.67; 95% confidence interval, 2.37-18.82), venous pH < 7.31 (5.89; 3.13-11.08), and postictal drowsiness > 30 minutes (1.90; 1.30-2.78) as the factors for RFS. Conclusion: In children with febrile seizure, focal seizure, acidosis, and prolonged postictal state may be independent risk factors for RFS. These findings may be informed to healthcare professionals and parents caring for children with febrile seizure.

참고문헌 (26)

  1. Green AL, "Duration of admission for febrile convulsions", Arch Dis Child, 60, pp.1182~1184 (1985)
  2. Jeong JH, "Rate of and risk factors for early recurrence in patients with febrile seizures", Pediatr Emerg Care, 30, pp.540~545 (2014)
  3. Park JK, "A clinical study of 347 children with febrile convulsion and risk factors of repeated convulsion", Hum Sci, 17, pp.371~379 (1993)
  4. Huang MC, "Parental responses to first and recurrent febrile convulsions", Acta Neurol Scand, 105, pp.293~299 (2002)
  5. Berg AT, "Predictors of recurrent febrile seizures. A prospective cohort study", Arch Pediatr Adolesc Med, 151, pp.371~378 (1997)
  6. Verity CM, "Long-term intellectual and behavioral outcomes of children with febrile convulsions", N Engl J Med, 338, pp.1723~1728 (1998)
  7. Annegers JF, "Factors prognostic of unprovoked seizures after febrile convulsions", N Engl J Med, 316, pp.493~498 (1987)
  8. Verity CM, "Risk of epilepsy after febrile convulsions : a national cohort study", BMJ, 303, pp.1373~1376 (1991)
  9. Pavlidou E, "Prognostic factors for subsequent epilepsy in children with febrile seizures", Epilepsia, 54, pp.2101~2107 (2013)
  10. Goldstein B, "International pediatric sepsis consensus conference: definitions for sepsis and organ dys-function in pediatrics", Pediatr Crit Care Med, 6, pp.2~8 (2005)
  11. Al-Marri MR, "Erythrocyte sedimentation rate in childhood tuberculosis : is it still worthwhile", Int J Tuberc Lung Dis, 4, pp.237~239 (2000)
  12. Lin L, "Clinical characteristics of neonatal fulminant necrotizing enterocolitis in a tertiary Children’s hospital in the last 10 years", PLoS One, 14, pp.e0224880~ (2019)
  13. Singh V, "Blood gas analysis for bedside diagnosis", Natl J Maxillofac Surg, 4, pp.136~141 (2013)
  14. Stanley FL, "Nelson textbook of pediatrics", pp.e5~e14 (2020), Elsevier
  15. Allen JE, "Recovery of consciousness after epileptic seizures in children", Arch Dis Child, 92, pp.39~42 (2007)
  16. El-Radhi AS, "Lower degree of fever at the initial febrile convulsion is associated with increased risk of subsequent convulsions", Eur J Paediatr Neurol, 2, pp.91~96 (1998)
  17. Hugen CA, "Serum sodium levels and probability of recurrent febrile convulsions", Eur J Pediatr, 154, pp.403~405 (1995)
  18. Schnaiderman D, "Antipyretic effectiveness of acetaminophen in febrile seizures : ongoing prophylaxis versus sporadic usage", Eur J Pediatr, 152, pp.747~749 (1993)
  19. Hirabayashi Y, "Efficacy of a diazepam suppository at preventing febrile seizure recurrence during a single febrile illness", Brain Dev, 31, pp.414~418 (2009)
  20. Hara K, "Febrile seizures associated with influenza A", Brain Dev, 29, pp.30~38 (2007)
  21. Mikati MA, "Nelson textbook of pediatrics", pp.3086~3121 (2020), Elsevier
  22. Lipka K, "Lactic acidosis following convulsions", Acta Anaesthesiol Scand, 47, pp.616~618 (2003)
  23. Orringer CE, "Natural history of lactic acidosis after grand-mal seizures. A model for the study of an anion-gap acidosis not associated with hyperkalemia", N Engl J Med, (;297), pp.796~799 (1977)
  24. Klllc TY, "Can venous blood gas analysis be used for predicting seizure recurrence in emergency department", World J Emerg Med, 5, pp.187~191 (2014)
  25. Nass RD, "Acute metabolic effects of tonic-clonic seizures", Epilepsia Open, 4, pp.599~608 (2019)
  26. Godinjak A, "Hyperlactatemia and the importance of repeated lactate measurements in critically ill patients", Med Arch, 71, pp.404~407 (2017)

관련 논문AI추천

이 간행물의 다른 논문 (6건)