Abstract Details

Title Determining Utility of Additional Days in the Epilepsy Monitoring Unit (EMU) for Patients without Events in First 5 Days of Admission

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 6-026

Objective

To identify characteristics predictive of non-diagnostic admission for differential diagnosis/classification EMU patients who have not had events in the first 5 days of admission.

Background

There is limited evidence-based guidance regarding appropriate timing of discharge from the EMU. In particular, it is unknown which patients without successful diagnosis early in their admission are likely to benefit from continued monitoring.

Design/Methods We performed a retrospective chart review of patients admitted to the EMU at the Hospital of the University of Pennsylvania between 1/2012 and 7/2017. Chi-squared tests and logistic regression modelling were used to investigate whether a variety of patient, EEG, and imaging characteristics could independently or in combination predict if a patient would go on to have a non-diagnostic stay.

Results We identified 198 patients with EMU length of stay >5 days without events in first five days of admission out of a total of approximately 1400 EMU admissions over a five year period. Absence of interictal discharges in the first 5 days was associated with non-diagnostic stay (p =.0009, OR = 2.90). Lack of motor semiology was also associated with non-diagnostic stay (p =.0267, OR = 2.36). The absence of both interictal discharges and major motor semiology had a positive predictive value of 82.8% for non-diagnostic admission. Demographic factors, lesional MRI, and number and type of AEDs did not influence likelihood of diagnostic or non-diagnostic stay.

Conclusions Non-motor semiology and the absence of interictal discharges predict non-diagnostic admission in patients admitted to the EMU for >5 days. These criteria may identify patients unlikely to benefit from prolonged EMU admission and thereby facilitate earlier discharge and improved EMU utilization.

Authors/Disclosures
Neena Cherayil, MD (Northwestern University Memorial Hospital) PRESENTER	Dr. Cherayil has nothing to disclose.
Pouya Khankhanian, MD (Kaiser Dublin)	No disclosure on file
Michael Gelfand, MD, PhD (University of Pennsylvania)	Dr. Gelfand has received personal compensation in the range of $0-$499 for serving as a Consultant for Aquestive. Dr. Gelfand has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Livanova. The institution of Dr. Gelfand has received research support from Aquestive. The institution of Dr. Gelfand has received research support from Xenon. The institution of Dr. Gelfand has received research support from Cerevel. The institution of Dr. Gelfand has received research support from UNEEG. The institution of Dr. Gelfand has received research support from Livanova. The institution of Dr. Gelfand has received research support from UCB. The institution of Dr. Gelfand has received research support from SK Pharma. The institution of Dr. Gelfand has received research support from Otsuka.

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