To assess whether adult patients with emergency department (ED) visits for falls are at an increased short-term risk of status epilepticus (SE).

This retrospective case-crossover study used data from the State Inpatient Databases and State Emergency Department Databases from New York (2018-2019) and Florida (2016-2019). Patients aged ≥ 18 years with an acute care visit for SE were identified using previously validated ICD-10 codes. We compared the risk of SE in 4 case periods (0-7 days, 8-30 days, 31-90 days, and 91-180 days before SE) to control periods 1 year prior using conditional logistic regression to estimate the association between short an ED visit for a fall and subsequent SE.

We identified 4,670 patients with SE, of whom 253 (5.4%) had an ED visit for a fall within the past 180 days. Patients with a fall were older, more likely to be female, had a higher Charlson Comorbidity Index, and a higher likelihood of both dementia and epilepsy. Falls were significantly associated with increased odds of SE for all time periods, and the risk appeared greatest in the 0-7 period following the fall (OR 3.38, 95% CI 1.49-8.60). Elevated risk persisted in later periods (8-30 days OR 1.83, 95% CI 1.09-3.15; 31-90 days OR 2.20, 95% CI 1.53-3.20; 91-180 days OR 1.72, 95% CI 1.24, 2.43).

ED visits for falls are associated with increased short-term risk of SE and represent opportunities for workup, monitoring, and prevention.