Point of Care Electroencephalography (POC-EEG) Is Associated with Reduced Hospital Length of Stay (LOS)
Abstract number :
3.255
Submission category :
3. Neurophysiology / 3B. ICU EEG
Year :
2024
Submission ID :
376
Source :
www.aesnet.org
Presentation date :
12/9/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Ioannis Karakis, MD, PhD, MS – University of Crete School of Medicine
Mariel Kalkach Aparicio, MD, MBE – University of Wisconsin-Madison
Masoom Desai, MD – University of New Mexico
Aaron Struck, MD – University of Wisconsin-Madison
Rationale: Prolonged non convulsive seizures (NCS) are associated with increased hospital length of stay (LOS). Previous analysis by this group have shown that access to point-of-care electroencephalography (POC-EEG) is associated with shorter length of stay in patients admitted to the intensive care unit (ICU) (Desai, et al, 2023). This study investigated whether detecting NCS early enough using POC-EEG is also associated with reduced overall hospital stay, with a sub-analysis whether any effects were different according to their EEG findings.
Methods: This was a retrospective cohort sub-analysis of the multicenter SAFER-EEG trial comparing hospital LOS between adult patients receiving an FDA-cleared POC-EEG (Ceribell, Inc) and those receiving conventional EEG (convEEG). Patient records from three academic centers during the period January 2018 to June 2022 were reviewed, and included adult patients admitted to the hospital and who received EEG monitoring as part of their standard of care. Propensity score matching was applied to control for potential confounders. Median and interquartile range were calculated for descriptive statistics. EEG findings were extracted from the neurology report, and abnormal EEGs were reviewed by the research team. The findings were classified as seizure, including status epilepticus, or as epileptiform or rhythmic patterns. Non-parametric tests (Mann-Whitney U) were used for continuous variables and Chi-square test for categorical variables.
Results: A total of 491 patients (133 convEEG and 358 POC-EEG) were included. The two populations were matched for demographic and clinical characteristics. For the whole cohort, we found that hospital LOS was significantly shorted in the POC-EEG group compared to the convEEG group [9.6 days (IQR: 4.9, 18.8) vs 11.8 days (IQR: 6.3, 27.3), p=0.02]. That difference sustained when controlling for potential confounders in the matched cohort [8.6 days (IQR: 4.6, 18.1) vs 11.8 days (IQR: 6.3, 27.3), p=0.009].
In the sub-analysis by EEG findings, we found that 42.5% of POC-EEG patients (N =152) had positive seizure or epileptiform and rhythmic activity findings (Sz/EA) and 39.8% of convEEG (N = 53) had similar findings. In the Sz/EA positive sub-group, the hospital LOS was significantly shorter for the POC-EEG than for the convEEG cohort [10.2 days (IQR: 5.1, 17.6) vs. 7.7 (IQR: 7.3, 30.2), p = 0.02].
Conclusions: This study revealed a significant association between early POC-EEG detection of epileptiform patterns and reduced hospital LOS, compared to conventional EEG monitoring, corroborating the benefit of early diagnosis. A causal relationship needs to be confirmed with future prospective randomized trials.
Funding: This study was supported by Ceribell, Inc.
Neurophysiology