Clinical and hematologic predictors of early intensive care unit admission in seizure patients presenting to the emergency room

Abstract

Objective: History of hypertension is a common comorbidity among patients with epilepsy, yet its role in acute seizure outcomes remains unclear. This study investigated whether history of hypertension and routine hematologic markers could predict intensive care unit (ICU) admission among patients with seizures presenting to the emergency room (ER). Methods: Ninety patients with confirmed seizures were retrospectively analysed. Demographic characteristics, comorbidities, and laboratory findings were compared between patients admitted to the ICU and those who were not. Multivariate logistic regression analysis identified independent predictors of ICU admission. In addition, all 20 ICU-admitted cases during the study period were further examined to characterize their clinical patterns. Results: Twenty patients (22.2 %) required direct ICU admission. History of hypertension was more frequent in the ICU group (45.0 % vs. 17.1 %, p = 0.009) and independently predicted ICU admission (OR 4.07, 95 % CI 1.05-15.80, p = 0.042). Elevated white blood cell counts (OR 1.27, 95 % CI 1.10-1.48, p = 0.002) and reduced red blood cell counts (OR 0.17, 95 % CI 0.05-0.59, p = 0.006) were also significant predictors. Conclusion: History of hypertension, leukocytosis, and anemia may indicate a higher risk of clinical deterioration in patients with seizures. These routinely available measures could assist early triage and management decisions in the ER. Prospective studies are warranted to confirm their prognostic utility.