A Study of the Clinical Profile of Paediatric Patients Admitted to the Emergency Department With Febrile Seizures

Background: Febrile seizures (FS) are the most common neurological event in childhood, particularly among children younger than five years.Despite their predominantly benign nature, they are a significant cause of paediatric emergency department (ED) attendance.This study aimed to characterise the clinical and epidemiological profile of children admitted to the observation ward (OW) of the Vila Real Hospital ED with FS between January 2020 and December 2024, and to compare simple and complex FS.Methods: A retrospective, descriptive study with an analytical component included 178 episodes in 126 children.Simple and complex episodes were compared with the chi-square, Fisher's exact, and Mann-Whitney U tests.Factors associated with complex FS were explored with logistic regression using Generalized Estimating Equations (GEE) to account for repeated episodes in the same child.Results: Boys accounted for 57.9% of children; the mean age at presentation was 25.5 months (median 19), and the 12-17-month age group was the most represented.In all, 78.1% of episodes occurred between November and May, and of 163 classifiable episodes, 126 (77.3%) were simple and 37 (22.7%)complex; 15 atypical episodes were described separately, and most complex episodes were classified by recurrence within the same illness (27 of 37).Upper respiratory tract infection (URTI) was the most frequent associated diagnosis (71.3%), and a virus was identified in 21.9% of episodes.Complex FS was associated with a longer OW stay (median 17.2 vs 12.8 hours, p = 0.007), more frequent hospital admission (64.9% vs 7.1%, p < 0.001), and greater use of EEG, head CT, lumbar puncture, and diazepam.No factor was independently associated with complex FS in an exploratory multivariable model.About a quarter of children (26.2%) had more than one episode during the study period, more often when the first recorded episode occurred before 18 months (39.2% vs. 17.3%, p = 0.008).Conclusions: These results align with published literature.Complex FS were associated with greater hospital resource utilisation and higher admission rates, and recurrence was more frequent in children with an earlier first episode.