2025 American Academy of Neurology Abstract Website

Objective:

To assess whether adult patients with emergency department (ED) visits for falls are at an increased short-term risk of status epilepticus (SE).

Background:

Falls are a common reason for ED visits, and result from multifactorial causes, including unrecognized seizures. These falls may signal an increased risk for recurrent seizure and SE, but to our knowledge, the association between ED visits for a fall and subsequent risk of SE has never been explored.

Design/Methods:

This retrospective case-crossover study used data from the State Inpatient Databases and State Emergency Department Databases from New York (2018-2019) and Florida (2016-2019). Patients aged ≥ 18 years with an acute care visit for SE were identified using previously validated ICD-10 codes. We compared the risk of SE in 4 case periods (0-7 days, 8-30 days, 31-90 days, and 91-180 days before SE) to control periods 1 year prior using conditional logistic regression to estimate the association between short an ED visit for a fall and subsequent SE.

Results:

We identified 4,670 patients with SE, of whom 253 (5.4%) had an ED visit for a fall within the past 180 days. Patients with a fall were older, more likely to be female, had a higher Charlson Comorbidity Index, and a higher likelihood of both dementia and epilepsy. Falls were significantly associated with increased odds of SE for all time periods, and the risk appeared greatest in the 0-7 period following the fall (OR 3.38, 95% CI 1.49-8.60). Elevated risk persisted in later periods (8-30 days OR 1.83, 95% CI 1.09-3.15; 31-90 days OR 2.20, 95% CI 1.53-3.20; 91-180 days OR 1.72, 95% CI 1.24, 2.43).

Conclusions:

ED visits for falls are associated with increased short-term risk of SE and represent opportunities for workup, monitoring, and prevention.