Abstract Details

Title Incidence of Seizure and Associated Risk Factors in Patients in the Medical Intensive Care Unit (ICU) at Memorial Sloan Kettering Cancer Center (MSKCC) In 2016-2017

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P16 - Poster Session 16 (5:30 PM-6:30 PM)

Poster/Presentation
Number 12-004

Objective

Our aims in this study are to determine the Incidence and risk factors of clinical and electrographic seizure in patients admitted to ICU at MSKCC in 2016-2017. This is the first study that investigates the incidence of both clinical and electrographic seizure in all patients admitted to ICU.

Background In ICU, seizures and status epilepticus are a common neurologic complication. It is important to properly diagnose the seizure type and its risk factors to ensure appropriate therapy.

Design/Methods Among 1,059 patients admitted to medical ICU at MSKCC from 2016 to 2017, data for patients who had EEG was obtained (n=184). We identified patients who had an electrographic seizure or clinical seizures.

Results The incidence of combined clinical and the electrographic seizure, clinical seizure, electrographic seizure, clinical seizure without EEG correlate, clinical seizure with EEG correlate, non-convulsive seizure (NSC), non-convulsive status epilepticus (NCSE), and convulsive status epilepticus (CSE) were 47.2, 40.6, 10.4, 35.9, 4.7, 7.6, 2.8, and 5.7 per 1000 respectively. History of seizure (OR:2.9, PV: 0.03), brain metastasis (OR: 2.5, PV: 0.03), being of vasopressor in ICU admission (OR: 2.2, PV: 0.05), Age<65 (1.4, 0.02), length of continuous EEG (OR:3.8, PV:0.01) increased the risk of clinical and electrographic seizures. Length of continuous EEG >24h significantly increased the risk of clinical and electrographic seizure detection (OR 2.5 and 10.8 respectively). Being on chemotherapy in the past 30 days increased the risk of electrographic seizure significantly by 10.4 folds (PV: 0.03).

Conclusions The ICU patient population with a history of seizure, brain metastasis, being of vasopressor in ICU admission, age<65, and being on chemotherapy in the past 30 days are in an increased risk of clinical and electrographic seizures. Length of continuous EEG >24h significantly increased the odds of clinical and electrographic seizure detection, therefore we recommend obtaining continuous EEG >24h in the high-risk patient population.

Authors/Disclosures
Saeedeh Azary, MD, MPH (Souther New Hampshire Health) PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Edward Avila, DO, F�鶹��ýӳ�� (Memorial Sloan-Kettering Cancer Center)	Dr. Avila has received publishing royalties from a publication relating to health care.

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