ArticleEpilepsia2026
Psychological stress during wartime and its association with seizure-related emergency department utilization.
Article in Epilepsia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePsychological stress is commonly reported as a seizure precipitant in epilepsy, yet evidence from major crises remains limited and inconsistent. We examined whether the October 2023 Israel-Hamas conflict affected acute seizure-related healthcare utilization among adults with epilepsy.
methodsWe conducted a retrospective cohort study of 34 941 adults with established epilepsy (International Classification of Diseases, Tenth Revision [ICD-10] G40 diagnosis ≥ 2 years prior) using the Clalit Health Services database in Israel. We compared seizure-related emergency department (ED) visits in two 1-year windows: pre-war (October 1, 2022-October 6, 2023) vs during-war (October 7, 2023-October 1, 2024). Primary outcome was ED visit rate per person-year. Given non-normal distributions, paired Wilcoxon tests assessed rate changes. Multivariable logistic regression identified predictors of worsening (during > pre), and Cox proportional hazards modeling evaluated time-to first ED visit, adjusting for demographics, socioeconomic status (SES), and comorbidities including dementia and post-traumatic stress disorder (PTSD).
resultsOverall 3056 patients (8.8% of cohort) experienced a during-war ED visit. Cohort-level visit rates were similar across periods (224.13 vs 217.34 per 1000 person-years; rate ratio .97, 95% confidence interval [CI] .94-1.00). Among 1039 patients with ED visits in both periods, median within-patient change was negligible (-0.003 visits per person-year), but the distribution shifted toward lower wartime rates (Wilcoxon Z = -3.11, p = .002; paired t test p = .730). Dementia and older age were associated with the shift was toward lower wartime rates. Odds of worsening were negligibly higher with age (odds ratio [OR] = 1.007). Older age (hazard ratio [HR] = 1.03) and dementia (HR = 1.20) predicted earlier ED visits, whereas PTSD (HR = .73) and higher SES (HR = .82) reduced hazard. SIGNIFICANCE: War-related stress correlated with stable seizure-related acute care utilization, with minor redistribution among recurrent ED users. Older age and dementia identify vulnerable subgroups requiring enhanced monitoring during national emergencies. Targeted monitoring and clinical support for high-risk patients with epilepsy may help reduce acute seizure-related ED utilization during high-stress situations.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.