Date of Award

2008

Degree Type

Thesis

Degree Name

Master of Science

Program

Epidemiology and Biostatistics

Supervisor

Dr. Kathy Speechley

Second Advisor

Dr. Gary Joubert

Third Advisor

Dr. Amardeep Thind

Abstract

Objective: To estimate the proportion of seizure presentations to London EDs that could be classified as “potentially deferrable” (PD), defined as cases that ωuld be more appropriately cared for in a non-ED setting. To compare non-deferrable patients with PD patients in terms of age, sex, seizure presentation characteristics, history of seizures and health care resource use. Methods: Chart review conducted of patients identified with a seizure that reported to any of the 3 ED sites in London in 2005. Criteria were developed a priori to classify visits as non-deferrable or PD. Epidemiological model building was used to determine explanatory factors for visit deferability. Results: 830 patients presented to an ED, with a total of 1200 visits, 37% were PD. Age, triage code, use of hospital resources, length of stay, witnessed seizures, history of seizures and seizure medications were significantly associated with deferability. Conclusion: One-third of visits were PD, presenting an opportunity for educational intervention.

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