Abstracts

Rationale: Continuous EEG (cEEG) monitoring is widely used in the ICU setting to detect seizures, especially non-convulsive seizures and status epilepticus. With increased availability of CEEG, there has been increased utilization of cEEG to monitor inpatients outside the ICU. The utility and impact of such monitoring in non-ICU patients is largely unclear.Methods: Patients who underwent cEEG monitoring outside of an ICU at Duke University Hospital between January and June of 2011 and of 2014 were retrospectively identified. The charts were reviewed for reason for admission, admitting service (Neuro-related vs. non-Neuro-related), indication for cEEG (altered mental status, spells, observed seizures) comorbid conditions, duration of recording, EEG findings, whether or not an event/seizure was recorded, and impact on treatment. For admitting service, neuro-related services included Neurology, Neurosurgery and Neuro-oncology; all other services were classified as non-neuro-related. We evaluated the impact of the year of recording, admitting service, indication for cEEG and neurological comorbidity on the yield of recordings based on whether or not an event was captured and/or a change in AED management occurred.Results: 249 non-ICU patients had cEEG monitoring during these periods, 134 in 2011 and 115 in 2014. The indication for cEEG was altered mental status (60.6%), observed seizures (26.5%), observed spells (12.9%). 63.5% were on neuro-related services. EEG findings included: epileptiform discharges (14.9%), periodic lateralized discharges (4%), generalized periodic discharges (1.6%). The average duration was 1.8 days. The yield of studies (events, seizures and change in AED) and the impact of admitting service, admitting diagnosis, indication for cEEG and year of study on yield is summarized in Table 1.Conclusions: In non-ICU patients, cEEG monitoring had a relatively high yield of event/seizures (similar to ICU) and impact on management. Temporal trends, admitting service and indication for cEEG did not alter this significantly. The admitting diagnosis did have an impact.