Akademik Veri Yönetim Sistemi
Turkiye Klinikleri Pediatri, cilt.20, sa.1, ss.16-21, 2011 (Scopus)
Objective: The necessity of routine laboratory investigations without regard to medical history and detailed physical examimation in the diagnosis and treatment of children with seizures in the emergency department is unclear. In this study we aimed to evaluate the significance and the cost of laboratory tests in children with seizures who were admitted to the emergency room. Material and Methods: In our retrospective study, 403 children (mean age: 50.4±40.1 months; range: 0.2-170 months; 241 males/162 females) with seizures who were admitted to the emergency room were evaluated between 01.01.2006-31.12.2006. The patients with status epilepticus were excluded. In all cases, complete blood count and routine biochemical tests were performed. Clinically significant serum chemistry abnormalities were those falling outside of the normal range and resulting in either a direct alteration of patient management or a specific discharge diagnosis. Results: 211 (52.4%) cases were diagnosed as febrile seizures. Although, 257 (63.7%) children had complete blood count abnormalities and 124 (30.7%) had biochemical abnormalities. Hyperglycemia (62 cases), hypokalemia (18 cases) and hypocalcemia (13 cases) were the most frequent biochemical abnormalities. Clinical significant laboratory abnormalities were determined in only seven (1.7%) children (4 cases with hypoglycemia, 2 with severe anemia and 1 with hyponatremia). The total cost of the emergency examination and routine laboratory research in all of the children with seizures was calculated as 10413.52 TL. The part of 4094.64 TL (39.3%) of this amount constituted the cost of non clinical significant laboratory tests. Conclusion: Except newborns and children with status epilepticus, routine laboratory research does not guide the diagnosis and treatment in children with seizures, and it leads to increased cost. Copyright © 2011 by Türkiye Klinikleri.