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Abstract

Objective: To investigate predictive factors for seizure recurrence in children with febrile seizures (FS) within a single febrile illness, providing a basis for early clinical identification and preventive measures. Methods: We conducted a retrospective analysis of children with FS admitted to the Department of Pediatrics, Suzhou Hospital Affiliated to Anhui Medical University, from April 2023 to December 2025. A total of 337 children met the inclusion criteria. Children with more than one seizure within the same febrile ilness were classified as the recurrent febrile seizures (RFS) group, and those with a single seizure as the non-recurrent febrile seizures (NRFS) group. Univariate and multivariate analyses identified factors associated with FS recurrence. A predictive model was constructed, and its performance was evaluated using the receiver operating characteristic (ROC) curve. Results: Among the 337 children, 42 were in the RFS group and 295 in the NRFS group. Multivariate logistic regression revealed that a family history of FS in first-degree relatives (OR = 2.853, 95% CI: 1.400-5.817, P = 0.004), body temperature at the first seizure (OR = 0.214, 95% CI: 0.099-0.465, P < 0.001), and serum potassium level (OR = 2.934, 95% CI: 1.227-7.014, P = 0.015) were independent risk factors for RFS. The predictive model demonstrated good discriminatory ability, with an area under the ROC curve (AUC) of 0.808 (95% CI: 0.746-0.869), a sensitivity of 71.4%, and a specificity of 75.7%. Conclusion: A positive family history of FS in first-degree relatives, a lower body temperature at the first seizure, and a higher serum potassium level are significant predictors of FS recurrence. Combining these indicators into a predictive model can effectively identify children at high risk of recurrence, offering a reference for early clinical intervention.

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