SEIZURES ASSOCIATED WITH FEVER - CLINICAL-DATA AS PREDICTORS FOR NORMAL BIOCHEMICAL BLOOD-LEVELS

We developed a predictive model to assess the probability of normal bi ochemical blood test results in children presenting with a seizure ass ociated with fever. The models were based on various combinations of p atient characteristics of the history and physical examination of 203 children. The characteristics included gender, age in years, previous history of febrile seizures, family history of febrile seizures, fever previous to the seizure, vomiting and diarrhoea previous to the seizu re. Further, clinical characteristics of the seizure were considered: focal seizure signs, multiple seizure, seizure duration and rectal tem perature at seizure. The outcome was defined as normal test results of serum levels of sodium (n = 115, 68%). calcium (n = 149, 89%) and glu cose (n = 173, 100%), according to the hospital reference values. The prevalence of abnormal test results was rather low and the abnormaliti es were outside the morbidity range. We used logistic regression to re late the outcome to the several clinical characteristics. The discrimi native ability of the models was 0.63 (area under the receiver operati ng characteristic curve of the model predicting normal sodium), 0.66 ( normal calcium) and 0.66 (both normal). The score chart we constructed is an additional tool to a carefully performed patient history and ph ysical examination and it may help to decide if a biochemical test is indicated for the individual patient. Conclusion In children with seiz ures associated with fever, abnormal biochemical-blood test results ar e rare and outside the morbidity range. The biochemical tests ase gene rally not required. In children with a low probability of a normal res ult as calculated by the score chart, the test may be indicated.