The Safety and Efficacy of Modifying the Admission Protocol to Epilepsy Monitoring Unit (EMU) in Response to COVID-19 Pandemic
Abstract number :
2.113
Submission category :
4. Clinical Epilepsy / 4C. Clinical Treatments
Year :
2021
Submission ID :
1825536
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:44 AM
Authors :
Fawzi Babtain, MBBS, MHSc, FRCPC, CSCN (EEG, EMG) - King Faisal Specialist Hospital aand Research Center; Khalid Al Qadi, MD - Neurologist, Neuroscience, King Faisal Specialist Hospital aand Research Center; Saleh Baeesa, MD, FRCPC - Neurosurgeon, Neurosciences, King Faisal Specialist Hospital aand Research Center; Youssef Alsaid, MD - Neurologist, Neuroscience, King Faisal Specialist Hospital and Research centre
Rationale: COVID-19 pandemic impacted the admission to EMU for classification, and presurgical evaluation of refractory epilepsy patients. We modified EMU admission protocol, by AEDs withdrawal one day before admission, and we aimed to evaluate if the modified protocol is safe and effective to improve the efficiency of EMU service.
Methods: Starting in January 2021, we initiated AEDs tapering 24 hours prior to EMU admission, in contrast to the previous protocol of AEDs tapering the first day after admission. We retrospectively reviewed EMU admissions for the first 4 months of 2018, 2019, and 2021, and identified the time required to record the first seizure, and also EMU yield to confirm or change epilepsy classification.
Results: We included 104 patients. Table 1 summarized patients’ demographics. Apart from the longer disease duration and the abundance of normal routine EEGs in the patients admitted before the pandemic, no other differences were observed. On average, it took 41 hours to record the first seizure during the standard admission protocol, and 21 hours using the modified protocol (p < 0.001, 95% CI; 10, 30 hours). Other patients’ characteristics investigated before and following the pandemic are shown in diagram 1. Multivariate regression analysis continued to show a shorter time to record the first seizure during “COVID-19” modified admission protocol (23 hours shorter, p < 0.001, 95% CI; 12 , 34 hours less). We also confirmed the classification of epilepsy 2 times more, using the modified protocol (OR=2.4, p =0.04, 95% CI; 1.1, 5.5). No significant differences in the number of seizures between the two protocols (diagram 1).
Clinical Epilepsy