Retrospective cohort study reveals risk factors for recurrent febrile seizures in pediatric patients, suggesting potential for early risk prediction.
Key Points
To identify independent risk factors and develop a clinical model to predict seizure recurrence within a single febrile episode in children.
Retrospective analysis of 337 children with febrile seizures admitted to a single pediatric hospital from April 2023 to December 2025.
Patients were categorized into recurrent febrile seizures (RFS, >1 seizure in the episode) and non-recurrent febrile seizures (NRFS) groups.
Univariate and multivariate logistic regression analyses were conducted to isolate predictors, and model performance was evaluated using receiver operating characteristic (ROC) curves.
Of 337 children, 42 experienced recurrence (RFS) and 295 had a single seizure event (NRFS).
Independent risk factors for recurrence were a family history of febrile seizures in first-degree relatives (OR = 2.853, 95% CI: 1.400–5.817, P = 0.004), body temperature at first seizure (OR = 0.214, 95% CI: 0.099–0.465, P < 0.001), and higher serum potassium levels (OR = 2.934, 95% CI: 1.227–7.014, P = 0.015).
The predictive risk model achieved an area under the ROC curve (AUC) of 0.808 (95% CI: 0.746–0.869), with a sensitivity of 71.4% and a specificity of 75.7%.