Abstract Details

Title Emergency Department Presentations and Inpatient Outcomes Following Epilepsy Consultation: A Retrospective Analysis at a Tertiary Academic Center

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P11 - Poster Session 11 (11:45 AM-12:45 PM)

Poster/Presentation
Number 11-003

Objective To describe characteristics of adult inpatients evaluated by an Epilepsy Consult Service and assess associations between consultation timing, length of stay (LOS), and discharge disposition.

Background Timely epilepsy consultation is critical for diagnosis and inpatient management of seizure-related presentations. Few studies have examined ED presentation patterns, consultation timing, and their impact on hospital outcomes.

Design/Methods A retrospective chart review was conducted of adults (≥18 years) admitted between November 2022 and February 2025 and evaluated by the Epilepsy Consult Service, staffed by five epileptologists, two nurse practitioners, and 24/7 EEG services, including continuous video EEG. Data collected included demographics, ED presentation, consultation indication, time from ED arrival to consult, LOS, and disposition. Early consults were defined as ≤12 hours from ED arrival. Multivariable linear regression analyzed LOS and logistic regression assessed discharge home, adjusted for age, sex, and ED presentation type. Spearman’s correlation evaluated time-to-consult versus LOS. Kaplan-Meier analysis explored time to seizure-related readmission.

Results Among 702 patients (mean age 55.1 ± 17.4 years, 52.6% male), the most common ED presentations were seizure or seizure-like events (61.8%), altered mental state (22.4%), and suspected stroke (6.7%). Median time to consult was 18 hours (IQR 0.5–47); 28% received early consultation (≤12 hours). Early consults were associated with shorter LOS (β = −1.5 days, p = 0.03) and higher odds of discharge home (OR 2.0, 95% CI 1.3–3.1, p = 0.01), after adjusting for age, sex, and ED presentation. LOS correlated positively with time-to-consult (ρ = 0.21, p = 0.01). Kaplan-Meier analysis suggested a longer median time to seizure-related readmission for early consult patients.

Conclusions Early epilepsy consultation (≤12 hours), supported by a dedicated team and 24/7 EEG, is associated with shorter hospitalization, improved discharge outcomes, and delayed readmission. Early involvement of epileptologists represents a scalable strategy to optimize inpatient seizure management.

Authors/Disclosures
Diji Johnson, MBBS PRESENTER	Dr. Johnson has nothing to disclose.
Rajesh C. Sachdeo, MD	Dr. Sachdeo has nothing to disclose.
Rahul Guha, MD (Jersey Shore University Medical Center)	Dr. Guha has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Experienced Neurology Consulting.
Alexander Buslov, MD	Dr. Buslov has nothing to disclose.
Arun R. Antony, MD (Jersey Shore University Medical Center)	Dr. Antony has nothing to disclose.

��ɫ��

��ɫ��