Fernando Spina Tensini, M.D., Ph.D. Universidade Federal do Paraná, CHC, Curitiba PR, Brasil.
Dr. Aroldo Bacellar et al. conducted this prospective study at Hospital San Rafael, in Salvador, Bahia, entitled “Predictors of long length of hospital stay among elders admitted with seizures in a tertiary center: a prospective study”, and aimed to answer which are predictive factors for longer hospital stays in elderly patients who have been admitted for epileptic seizures or who have developed them during hospitalization.
From 2015 to 2019, 159 elderly people admitted to the San Rafael Hospital emergency room and followed up by the neurology team were included in the study. Several parameters were evaluated, such as the presence of other neurological diseases, clinical comorbidities, demographic data and, especially, characteristics related to epileptic seizures and the diagnosis of epilepsy, following the criteria of the ILAE (International League Against Epilepsy) (SCHEFFER, I. E. et al.). With these data, through multivariate analysis, it was possible to establish five important predictors of longer hospital stay: ICU admission, urinary tract infection, presence of movement disorders, early recurrence of epilepsy and sepsis.
Imagem: Robin Canfield.
The factors “ICU stay”, “Sepsis” and “Urinary infection” point to the importance of adequate clinical management, adequate use of bladder tubes and the constant surveillance for sepsis that must be maintained if we want to effectively reduce the length of hospital stay in these patients. The items “Recurrence of crisis” and “Movement Disorders” show how necessary it is to have a neurologist trained both for the accurate diagnosis, as well as for the appropriate treatment of the crisis and the maintenance of complex therapies already in use, as in the case of patients with Parkinson’s disease.
Future studies, in other centers in Brazil and the world, and with more homogeneous populations will be necessary to corroborate these data for the general population.
References
SCHEFFER, I. E. et al. ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology. Epilepsia [online]. 2017, vol. 58, no. 04 [viewed 26 January 2021]. https://doi.org/10.1111/epi.13709. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/epi.13709
To read the article, acess
BACELLAR, A. et al. Predictors of long length of hospital stay among elders admitted with seizures in a tertiary centre: a prospective study. Arq. Neuro-Psiquiatr. [online]. 2020, vol.78, n.11 [viewed 26 January 2021]. https://doi.org/10.1590/0004-282×20200062. Available from: http://ref.scielo.org/yd5hrd
External links
Arquivos de Neuro-Psiquiatria – ANP: https://www.scielo.br/anp
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