title: Hospital-onset seizures: an inpatient study.
abstract: OBJECTIVE
  To describe demographic and clinical characteristics of patients with hospital-onset seizure (HOS) and to explore current practices in their management.
  
  
  METHODS
  Retrospective medical record review.
  
  
  METHODS
  Academic, tertiary care, private (New York University Langone Medical Center) and municipal (Bellevue Hospital Center) medical centers.
  
  
  METHODS
  Patients aged at least 18 years with HOS from January 1 through December 31, 2007. Patients admitted for evaluation of seizures or epilepsy were excluded.
  
  
  METHODS
  Hospital-onset seizure patterns, medication use, and outcomes.
  
  
  RESULTS
  We identified 218 patients with HOS; 139 (64%) had no history of seizure. Hospital-onset seizures were recurrent in 134 patients (61%) during the inpatient stay and were more likely to recur in those with new-onset seizure vs those with a history of seizure (43% vs 32%, P = .09). The most commonly described HOS in patients with a history of seizure and patients with new-onset seizure was a generalized tonic-clonic seizure (72 [33%]). Metabolic derangements were the most common identifiable cause of HOS (43 of 218 [20%]) and new-onset seizures (35 of 139 [25%]) and were more likely to recur. Phenytoin was the most common antiepileptic drug prescribed de novo (61%). Death during hospitalization or discharge to hospice was more common in patients with new-onset seizures compared with those with a history of seizure (19% vs 5%, P = .004). Among surviving patients discharged with a prescription of antiepileptic drugs, phenytoin and levetiracetam were prescribed most often.
  
  
  CONCLUSIONS
  Hospital-onset seizures commonly occur as new-onset seizures, are typically recurrent, and are associated with a high mortality. Older antiepileptic drugs are often prescribed at seizure presentation and at discharge.
authors: Department of Neurology, Mount Sinai School of Medicine, One Gustave L. Levy Pl, New York, NY 10029, USA. Madeline.fields@mssm.edu
authors: Madeline C
authors: MC
authors: Fields
authors: Daniel L
authors: DL
authors: Labovitz
authors: Jacqueline A
authors: JA
authors: French
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use; D005260:Female; D006760:Hospitalization / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012640:Seizures / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*
chemical_list: D000927:Anticonvulsants