Abstracts

Rationale: The Seizures and Outcomes Study in Children (SOS-KIDS) examined the frequency and type of accidental injuries in children with epilepsy living in Washington DC and the factors associated with those injuries. In addition, we identified the occurrence of seizure-related injuries in caregivers, which was previously unreported.Methods: SOS-KIDS is a prospective cohort study of pediatric epilepsy patients and their caregivers living in DC and evaluated at Children’s National Health System. Patients are recruited at the time of their routine clinic appointment or inpatient visit. As part of data collection, caregivers complete a survey about the child’s epilepsy and associated outcomes. Questions include history and frequency of accidental and seizure-related injuries that required medical attention. Chi-square and Student’s t-test were used to compare the distribution and means of variables of interest in the injury and no injury groups.Results: Data were collected on 202 children (53% male, 47% female) of which 44 (21.8%) reported at least one accidental injury and 31 (15.3%) reported at least one seizure-related injury, all requiring medical attention. Factors significantly associated with a history of accidental injury included older age (9.6 versus 7.4 years, p=.009), longer duration of epilepsy (5.8 versus 3.7 years, p=.003), more years of seizures (5.0 versus 2.8 years, p=.0006), higher lifetime (p<.0001) and recent (p=.03) seizure frequency, and a diagnosis of autism (17.9% vs 5.7%, p=.04) or ADHD (38.5% versus 20.5%, p=.02) in those at least 3 years of age. Seizure severity, current number of AEDs, and a diagnosis of developmental delay were borderline significant (p=.07). Gender, seizure type, and cognitive delay or impairment were not related to a history of injury. A total of 139 accidental injuries and 58 seizure-related injuries occurred in 830 person-years of epilepsy for an incidence of 16.7% for accidental and 7% for seizure-related. The most common type of accidental and seizure-related injury was cut or abrasion (45.5% and 36.4%, respectively) followed by head injury (36.4% and 27.3%) and fracture (11.4% and 9.1%). Six caregivers (3.0%) reported being significantly injured during one of their child’s seizures and required medical attention.Conclusions: Serious accidental and seizure-related injuries are a relatively common morbidity in children with epilepsy and occur significantly more often in those with autism and ADHD, two diagnoses related to risk-taking behaviors. Injuries are also related to more frequent seizures and a longer duration of epilepsy, although not all injuries were seizure-related. Other injuries in our population may have been reduced, compared to the general pediatric population due to closer supervision, more physical disability, and restrictions from sports. Significant injury related to seizures extends to about 3% of caregivers who are hurt while attending to the seizing child. This study is supported by the Centers for Disease Control and Prevention.