Background: Febrile seizures (FS) are common childhood-onset seizures. The incidence of recurrence of FS during the same febrile illness (RFS) within 24 hours is 15–16%. However, the predictive factors for RFS are unknown.
Objective: To determine the possibility of predicting RFS based on the clinical data at the emergency department.
Methods: This was a cross-sectional, retrospective study in Atsugi City Hospital in Japan, conducted between December 1, 2018 and February 28, 2019. FS are defined as the seizures accompanied by body temperature ≥ 38.0℃ without central nervous system infection, occurring in children between 6–60 months of age. Exclusion criteria were multiple seizures before visiting the emergency department, diazepam administration before visiting the emergency department or when going home, seizures lasting > 15 minutes, underlying diseases (i.e. epilepsy, gastroenteritis, etc.), and no laboratory test at the emergency department. The primary outcome was RFS.
Results: Fifty-one patients fulfilled the inclusion criteria. The incidence of RFS was 17.6% (9/51) and all except one patient reported the recurrence of a seizure within 24 hours from the first seizure. The group with RFS showed significant prevalence in males (P=0.043) and a comparatively lower body temperature (P=0.013). After adjustment for possible confounding factors, RFS showed significant associations with males (odds ratio, 18.13; 95% confidence interval, 1.18–278.81; P=0.04) and body temperature (odds ratio, 0.13; 95% confidence interval, 0.02–0.75; P=0.02). In this cohort, body temperature cut-off value ≤ 39.4℃ and males showed specificity and negative predictive values of 78.6% and 86.8%, respectively.
Conclusion: The incidence of RFS was 17.6%. In this study, RFS was strongly related to a body temperature ≤ 39.4℃ and a prevalence in males. In future, a prospective and large-sized sample study will be needed to determine the predictive factors for RFS.