Pediatr Neurol. 2026 May 12;181:76-82. doi: 10.1016/j.pediatrneurol.2026.05.005. Online ahead of print.
ABSTRACT
BACKGROUND: Although not routinely recommended, computed tomography (CT) head are frequently performed in children presenting to emergency department (ED) with seizures. Racial and ethnic disparities have been reported in pediatric ED imaging. Our objective was to evaluate the association of demographic factors, including race and ethnicity, with CT head utilization in children presenting to ED with an unprovoked seizure.
METHODS: We conducted a retrospective cross-sectional analysis of the National Hospital Ambulatory Medical Care Survey from 2016 to 2022, including ED visits by patients ≤18 years of age whose first three listed reason-for-visit or diagnosis codes indicated epilepsy or unspecified convulsions. We collected patient demographics, CT head utilization and disposition. Complex samples-adjusted analyses included Pearson chi-square tests and multivariable logistic regression.
RESULTS: A total of 479 visits (weighted N = 3,936,090) met inclusion criteria. Majority was female (52.0%), publicly insured (62.9%), and non-Hispanic White (45.7%). CT head was performed in 23.6% of visits. CT utilization was higher among adolescents (38.8%). Adolescents had significantly higher odds of CT utilization compared with preschool and school-aged children (odds ratio: 3.28; 95% confidence interval: 1.87-5.74). No significant association was found between race/ethnicity and CT utilization in either bivariate or multivariate analysis.
CONCLUSIONS: In this nationally representative sample, CT head was performed in 23.6% of ED visits for unprovoked seizures. Age was associated with differences in CT utilization. No racial or ethnic disparities in CT utilization were observed. However, as multivariable estimates for race and ethnicity did not meet National Center for Health Statistics statistical reliability standards, these findings must be interpreted with caution.
PMID:42241796 | DOI:10.1016/j.pediatrneurol.2026.05.005
