Authors :
Presenting Author: Linda Sherine Alfred, MD – University of Tennessee Health Science Center. Department of Neurology. Memphis, TN.
Mohammad Alzayadneh, MD – University of Tennessee Health Science Center
Raed Alkhaddash, MD – University of Tennessee Health Science Center
Reem El-Ghawanmeh, MD – University of Tennessee Health Science Center
Haewon Shin, MD – University of Tennessee Health Science Center. Department of Neurology. Memphis, TN.
Mahmoud Salhab, MD – University of Tennessee Health Science Center
Khalid Alsherbini, MD – University of Arizona College of Medicine/ Banner Health
Juan Goyanes, MD – University of Tennessee Health Science Center
Christa Nobleza, MD – University of Tennessee Health Science Center/ Baptist Memorial Hospital-Memphis
Rationale:
Rapid Electroencephalography (R-EEG) technology is a tool to be able to determine seizures at the bedside within 5 minutes of a concern for any seizure. As part of the institutional clinical protocol, conventional EEG (conv-EEG) can be done after the use of R-EEG if the clinician has continued concern for undetected seizures. However, the quantified necessity of conv-EEG after R-EEG remains to be unclear. This study aims to determine the necessity of conv-EEG after R-EEG by determining information were gained by doing conv-EEG and patient outcomes of patients who underwent conv-EEG after R-EEG.
Methods:
A single-center retrospective study was done to analyze the utility of conv-EEG after R-EEG in Baptist Memorial Hospital Memphis (BMH-Mem), from September 1, 2023 to November 30, 2023. All adult patients (18-89 years old) admitted to BMH-Mem who were admitted to the ER or ICU who underwent R-EEG were included. Patients transitioning to comfort focused care within 24 hours of admission were excluded. Ceribell ™ R-EEG technology cloud data and Epic ™ EMR were reviewed. The patients were divided into R-EEG+conv-EEG vs. R-EEG-only, and in addition, new findings from those who underwent Conv-EEG were analyzed. Primary outcome is the proportion of patients having additional information on conv-EEG compared to R-EEG. The type of findings were also quantified. Patient demographics and outcomes between the cohorts were compared. Descriptive statistics were utilized as applicable. Chi-square and t-test were used to compare demographic, EEG and outcome characteristics as applicable, using SPSSv29™.
Results:
A total of 117 patients, 60% (n= 70) of whom are female with a mean age of 63±18 years, underwent R-EEG during the study period. Majority of R-EEG were performed in the ICU (68,59%) for encephalopathy (59, 50%), at night-shift (65,56%), with overall seizures reported from R-EEG at 12% (n= 10) with a mean seizure burden of 12±25.41%. The R-EEG+Conv-EEG and R-EEG-only cohort had comparable characteristics,
A total of 81 (69%) underwent conv-EEG after R-EEG. Among these, 24% (n=28) had new EEG findings among all patients who underwent R-EEG after conv-EEG was done. There were 15 (13%) new seizures and 13 (11%) new epileptiform discharges.
There was no significant difference in mean hospital length of stay (62.7±18.81 vs 62.75±19.28 days, p=.990) and discharge disposition between the R-EEG+Conv-EEG cohort compared to the R-EEG-only cohort, and majority of the patients went home for both groups (41,51% vs 15,43%, p=0.175).
Conclusions:
This study quantified the value of Conv-EEG after R-EEG and showed that Conv-EEG showed new findings in 24% of patients undergoing R-EEG. Majority of the additional findings were electrographic seizures. These findings, however, did not show significant impact on patient outcome. Further prospective and larger studies should analyze the practice of performing Conv-EEG after R-EEG and its impact on patient outcomeFunding: No funding support for this abstract is declared by all authors.