Background: Seizure is a common neurological presenting symptom at the emergency department (ED). Recurrent seizure may result in an overcrowded ED and affect morbidity. Factors associated with recurrent seizure in Thailand or other developing countries are limited. Methods: Clinical features of adult patients who presented with seizure at the ED, Ramathibodi Hospital, Mahidol University, Thailand were retrospectively reviewed. Factors associated with recurrent seizure were identified by multivariate logistic regression analysis. Results: During the study period, there were 65,586 patients who visited the ED. Of those, there were 156 seizure patients who were identified for analysis. The mean (S.D.) age of all patients was 47.44 (19.80) and males accounted for 41.67%. There were 40 patients who had recurrent seizures (25.64%). There were 10 significant factors associated with recurrent seizure at the ED. Of those, seven factors had a positive association with recurrent seizure; the top three factors were seizure attacks >4 times prior to ED visit, age >70 years and cerebral infarction, while the other three factors were negatively associated (history of antiepileptic drugs, brain surgery and alcohol consumption). Conclusions: Recurrent seizure at the ED may be related to seizure history prior to the ED visit, age, cause of seizure, and co-morbid conditions.
Seizures

BACKGROUND:In emergency conditions, the actual weight of infants and young children are essential for treatments. The RAMATHIBODI Pediatric Emergency Drug Card or RAMA Ped Card has also been developed to estimate actual weight of the subjects. This study aimed to validate the RAMA Ped Card in correctly identifying the actual weight of infants and young adults. METHODS:This study was a prospective study. We enrolled all consecutive patients under 15 years of age who visited the emergency department (ED). All eligible patients' actual weight and height were measured at the screening point of the ED. The weight of each patient was also measured using the unlabeled RAMA Ped Card. The Cohen's kappa values and agreement percentages were calculated. RESULTS:During the study period, there were 345 eligible patients. The RAMA Ped Card had a 61.16％ agreement with the actual weight with a kappa of 0.54 (P<0.01), while the agreement with the actual height had a kappa of 0.90 and 91.59％ agreement. Sub-group analysis found kappa scores with good range in two categories:in cases of accidents and in the infant group (kappa of 0.68 and 0.65, respectively). CONCLUSION:The RAMA Ped Card had a fair correlation with the actual weight in child patients presenting at the ED. Weight estimation in infant patients and children who presented with accidents were more accurate.