The role of demographic factors of individuals with seizures in emergency care delivery

Document Type

Journal Article

Publication Date

3-1-2026

Journal

Epilepsy & behavior : E&B

Volume

176

DOI

10.1016/j.yebeh.2026.110923

Keywords

Emergency department; Epilepsy; Healthcare disparities; Seizures; Socioeconomic factors

Abstract

OBJECTIVE: To determine whether patient demographics, specifically race and ward of residence, are associated with differences in seizure-related emergency department (ED) care delivery. METHODS: We conducted a retrospective study of adults presenting with epileptic or functional seizures to the ED at the George Washington University (2018-2020). Each visit was mapped to one of Washington, D.C.'s eight wards, and patients were stratified by race and ward (White vs. Black patients from wards 1-6 or wards 7-8). Key ED interventions and outcomes (antiseizure medication (ASM) administration, head CT imaging, toxicology screening, ED length of stay) were compared across groups using multivariable logistic regression and linear/mixed-effects models. RESULTS: Among 324 ED visits analyzed, Black patients had significantly higher odds of receiving an emergency ASM than White patients. They also experienced longer ED stays on initial visits. CT imaging appeared more common among patients from the most underserved wards (40% in Wards 7-8 vs ∼ 27% in other groups); however, in adjusted comparisons, neither CT nor toxicology utilization differed significantly by race/ward. No racial/ward differences in ED stay were observed in repeat-visit patients. SIGNIFICANCE: Black patients from disadvantaged wards made more frequent and prolonged ED visits for seizures, requiring urgent treatment more often than others. These findings suggest that systemic disparities in outpatient epilepsy care and resource access contribute to uneven acute care utilization, underscoring the need for interventions to ensure equitable seizure management.

Department

Neurology

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