Racial and Ethnic Differences in Hospital Admission and Diagnostic Evaluation for Febrile Seizures in the Emergency Department

• Published in: The Journal of pediatrics 2024-06, Vol.269, p.113960, Article 113960
• Main Authors: Raschein, Taryn S., Lammers, Shea, Nickel, Amanda, Louie, Jeffrey P., Bergmann, Kelly R.
• Format: Article
• Language: English
• Subjects: Black or African American - statistics & numerical data; Child; Child, Preschool; Cross-Sectional Studies; Emergency Service, Hospital - statistics & numerical data; Ethnicity - statistics & numerical data; Female; Hispanic or Latino - statistics & numerical data; Hospitalization - statistics & numerical data; Humans; Infant; lumbar puncture; Male; neuroimaging; Neuroimaging - statistics & numerical data; race and ethnicity; resource utilization; seizure; Seizures, Febrile - diagnosis; Seizures, Febrile - ethnology; Spinal Puncture - statistics & numerical data; United States; White People - statistics & numerical data
• ISSN: 0022-3476; 1097-6833; 1097-6833
• DOI: 10.1016/j.jpeds.2024.113960

To examine differences in hospital admission and diagnostic evaluation for febrile seizure by race and ethnicity. We conducted a cross-sectional study among children 6 months to 6 years with simple or complex febrile seizure between January 1, 2016, and December 31, 2021, using data from the Pediatric Health Information System. The primary outcome was hospital admission. Secondary outcomes included the proportion of encounters with neuroimaging or lumbar puncture. We used mixed-effects logistic regression model with random intercept for hospital and patient to estimate the association between outcomes and race and ethnicity after adjusting for covariates, including seizure type. In total, 94 884 encounters were included. Most encounters occurred among children of non-Hispanic White (37.0%), Black (23.9%), and Hispanic/Latino (24.6%) race and ethnicity. Black and Hispanic/Latino children had 29% (aOR 0.71; 95% CI 0.66-0.75) and 26% (aOR 0.74; 95% CI 0.69-0.80) lower odds of hospital admission compared with non-Hispanic White children, respectively. Black and Hispanic/Latino children had 21% (aOR 0.79; 95% CI 0.73-0.86) and 22% (aOR 0.78; 95% CI 0.71-0.85) lower adjusted odds of neuroimaging compared with non-Hispanic White children. For complex febrile seizure, the adjusted odds of lumbar puncture was significantly greater among Asian children (aOR 2.12; 95% CI 1.19-3.77) compared with non-Hispanic White children. There were no racial differences in the odds of lumbar puncture for simple febrile seizure. Compared with non-Hispanic White children, Black and Hispanic/Latino children with febrile seizures are less likely to be hospitalized or receive neuroimaging.