University of Oulu

Kämppi, L, Puolakka, T, Ritvanen, J, et al. Burden of suspected epileptic seizures on emergency services: A population-based study. Eur J Neurol. 2023; 30: 2197-2205. doi:10.1111/ene.15800

Burden of suspected epileptic seizures on emergency services : a population-based study

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Author: Kämppi, Leena1; Puolakka, Tuukka2,3; Ritvanen, Jaakko4;
Organizations: 1Epilepsia Helsinki, European Reference Network EpiCARE, Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
2Department of Emergency Medicine and Services, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
3Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
4Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
5Department of Mathematical Sciences, University of Oulu, Oulu, Finland
6Department of Neurology, Tampere University Hospital and Tampere University, Tampere, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.9 MB)
Persistent link:
Language: English
Published: John Wiley & Sons, 2023
Publish Date: 2023-10-02


Background and purpose: Patients with acute epileptic seizures form a large patient group in emergency neurology. This study aims to determine the burden caused by suspected epileptic seizures at different steps in emergency care.

Methods: A retrospective, cross-sectional, population-based (>1,000,000 inhabitants), 4-year (2015–2018) study was conducted in an urban setting with a single dispatch centre, a university hospital-affiliated emergency medical service (EMS), and five emergency departments (EDs). The study covered all adult (≥16 years old) emergency neurology patients receiving medical attention due to suspected epileptic seizures from the EMS and EDs and during hospital admissions in the Helsinki metropolitan area.

Results: Epileptic seizures were suspected in 14,364 EMS calls, corresponding to 3.3% of all EMS calls during the study period. 9,112 (63.4%) cases were transported to hospital due to suspected epileptic seizures, and 3368 (23.4%) were discharged on the scene. 6969 individual patients had 11,493 seizure-related ED visits, accounting for 3.1% of neurology- and internal medicine-related ED visits and 4607 hospital admissions were needed with 3 days’ median length of stay (IQR=4, Range 1–138). Male predominance was noticeable at all stages (EMS 64.7%, EDs 60.1%, hospital admissions 56.2%). The overall incidence was 333/100,000 inhabitants/year for seizure-related EMS calls, 266/100,000 inhabitants/year for ED visits and 107/100,000 inhabitants/year for hospital admissions. Total estimated costs were 6.8 million €/year, corresponding to 0.5% of all specialized healthcare costs in the study area.

Conclusions: Patients with suspected epileptic seizures cause a significant burden on the health care system. Present-day epidemiological data are paramount when planning resource allocation in emergency services.

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Series: European journal of neurology
ISSN: 1351-5101
ISSN-E: 1468-1331
ISSN-L: 1351-5101
Volume: 30
Issue: 8
Pages: 2197 - 2205
DOI: 10.1111/ene.15800
Type of Publication: A1 Journal article – refereed
Field of Science: 3124 Neurology and psychiatry
Funding: The study was supported by Helsinki University Hospital (L.K., T.P., J.R., K.T.), Epilepsy Research Foundation in Finland (J.R., K.T.), Etelä- Karjalan lääkäriseurat (T.P.), Finska Läkaresällskapet (T.P.), Laerdal Foundation for Acute Medicine (T.P.), and Viipurin tuberkuloo-sisäätiö (T.P.).
Dataset Reference: The data that support the findings of this study are available on request from the corresponding author. The data are not publicly avail-able due to privacy or ethical restrictions.
Copyright information: © 2023 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.