Point-of-care EEG leads to better outcomes compared with conventional EEG

Key takeaways:

• The study noted delayed access to EEG while seizures are left untreated..
• The researchers said future studies should consider relevant covariates and other clinical outcomes.

ORLANDO — Patients with seizures who were given point-of-care electroencephalography had shorter time to initiation and shorter hospital stays compared with those given conventional EEG, according to research.

“The poster addresses a gap there is to have comprehensive neuromonitoring of patients who are at risk of seizures,” Mariel Kalkach Aparicio, MD, MBE, a research specialist in the neurology department at the University of Wisconsin, told Healio during a poster presentation at the American Epilepsy Society annual meeting. “(There is) an unmet need for patients who are likely to seize at the moment which they receive EEG care.”

Kalkach Aparicio and colleagues attempted to contrast the impact of point-of-care electroencephalography (POC-EEG) with conventional EEG (ccEEG) by examining patient status at time of EEG, time to access as well as length of hospital stay following EEG initiation.

Their retrospective, multicenter study (SAFER-EEG) analyzed data from four academic hospitals in the United States (Massachusetts General Hospital, Yale University, the University of New Mexico and the University of Wisconsin). From 1,074 records, a total of 198 seizure-positive adults were found, divided into two cohorts — those who received cEEG alone (n = 138; mean age 61 years; 46% female) or those receiving POC-EEG, either alone or followed by cEEG (n = 60; mean age 65 years; 57% female). All individuals in the analysis experienced a seizure and were given 1 hour of POC-EEG or 4 hours of cEEG, performed between January 2018 and June 2022. Researchers also analyzed and compared a subset of individuals who had a seizure within 1 minute of EEG commencement, along with clinical status of patients from EEG initiation and length of time from EEG initiation to hospital discharge, as well as time from hospital admission to EEG initiation.

According to results, seizure-positive individuals given cEEG waited for a median of 5.9 hours from admission to initiation, while patients given POC-EEG waited a median of 3.6 hours.

Researchers additionally found, among those who began seizing at EEG initiation, median time to cEEG was 5.7 hours and the median hospital stay was 8.4 days. Conversely, for the same population given POC-EEG, median time to initiation was 0.6 hours and median hospital stay was 2.8 days.

The researchers said future studies should focus on length of stay and other clinical outcomes.

“We also found that 27% of patients who get a conventional EEG will have seizures at the moment which the EEG is placed versus 6% of those who have rapid EEG,” Kalkach Aparicio told Healio. “That’s a significant difference telling us the importance of time.”