Abstract Details

Title How Long is a Piece of String? A Retrospective Study of the Correlation Between Length of Stay in Epilepsy Monitoring Unit and Diagnostic Yield

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P18 - Poster Session 18 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-004

Objective

The aim of our study is to examine the correlation between the length of stay (LOS) in the epilepsy monitoring unit (EMU) for evaluation purposes and diagnostic yield.

Background Continuous video EEG (cvEEG) monitoring is the gold standard in the evaluation of seizures and other paroxysmal events. However, the utility of this valuable diagnostic tool is limited by the extensive resource it requires including financial resource, need for highly trained individuals and hospital bed availability. With additional day of monitoring, more resources are being consumed per patient. It is thus essential to evaluate the relationship between length of stay and diagnostic yield

Design/Methods A retrospective review of patients admitted to EMU in a tertiary referral center for diagnostic evaluation of spells was performed. We gathered all the clinical data, demographics, cvEEG analysis and diagnostic reports to patients admitted to our EMU from January 2016 to July 2021. The relative risk of achieving a diagnosis with 95% Confidence Interval (CI) was generated by comparison of risks between ≤five days versus LOS of >five days.

Results 503 patients were included in the study. The median (LOS) was seven days (range 1 to 17 days). The median time to the first event was two days (range 1 to 17 days). 87.3% of patients had conclusive studies. 65.7% of patients received a diagnosis within the first seven days with the highest during day seven. 34% of patients received a diagnosis after cvEEG beyond seven days. The rate of diagnosis achieved decreases after seven days. The relative risk of achieving conclusive studies decreases with additional days of cvEEG beyond five days.

Conclusions Our study suggested that prolonging LOS was not associated with better diagnostic yield but there is a cumulative increase in diagnostic yield over time andmore prolonged length of stay may be necessary for some patients.

Authors/Disclosures
Mohammad Hijaz Adenan, MBBS (Royal COllege of Surgeons Ireland) PRESENTER	Dr. Adenan has nothing to disclose.
	No disclosure on file
Kai Sheng Loh, MBBS (Beaumont Hospital)	Dr. Loh has nothing to disclose.
Arif A. Shukralla, MD	Dr. Shukralla has nothing to disclose.
Stephen P. Klaus, MB, BCh, BAO, MSc	Dr. Klaus has nothing to disclose.
Michael O. Kinney, MD	Dr. Kinney has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Arvelle Therapeutics .
	No disclosure on file
Norman Delanty, MD (Beaumont Hospital)	No disclosure on file

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