Lumbar puncture refusal in febrile convulsion.

Area of Science:

• Pediatrics
• Neurology

Background:

• Febrile convulsions are common in children.
• Lumbar puncture (LP) is a crucial diagnostic tool for managing febrile convulsions.
• Understanding factors influencing LP refusal is vital for improving patient care.

Purpose of the Study:

• To determine the rate of lumbar puncture refusal in patients with febrile convulsions.
• To identify factors associated with lumbar puncture refusal.
• To assess the outcomes of patients who refused lumbar puncture.

Main Methods:

• A descriptive study was conducted over a two-year period.
• Data were collected on patients admitted for febrile convulsions.
• Analysis focused on the rate of LP refusal, associated factors, and patient outcomes.

Main Results:

• 19% of patients indicated for LP refused the procedure.
• LP refusal was significantly higher in the Malay ethnic group (p = 0.01).
• Refusal was not significantly associated with age, gender, or first-time vs. recurrent convulsions.
• Half of patients refusing LP were empirically treated for meningitis.
• Patients refusing LP were 8.5 times more likely to discharge themselves against medical advice (AOR) (p = 0.004).

Conclusions:

• Lumbar puncture refusal presents a significant challenge in managing febrile convulsions.
• Public education, especially for the Malay ethnic group, on LP safety and utility is needed.
• Addressing reasons for 'at own risk' discharges following LP refusal is crucial for improving care.