Abstract Details

Title Assessing the Value of Interhospital Transfer for Patients with Suspected Status Epilepticus (SE)

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 12-002

Objective To assess the frequency at which refractory seizures are detected by continuous EEG monitoring (CEEG) in patients transferred for management of suspected status epilepticus (SE).

Background Patients presenting with suspected SE are often transferred to CEEG-equipped tertiary care facilities to detect nonconvulsive seizures refractory to medication and inform decisions to increase antiepileptic doses and/or refer for surgical intervention. But when no such refractory seizures are present, interhospital transfer is unlikely to provide clinical benefit, thus exposing critically ill patients to the risk and burden of transfer unnecessarily and inefficiently allocating tertiary care beds. No studies have explored the rate at which CEEG detects refractory seizure activity in suspected SE patients after transfer.

Design/Methods We conducted a retrospective chart review on adults (≥18 yrs.) transferred to Mount Sinai Hospital between 1/1/17 and 10/1/19 for management of SE. Reports of CEEG studies conducted within 72 hours of MSH admission were examined for seizures and findings consistent with SE. Admission and discharge times were reviewed. Patients without CEEG reports were excluded.

Results 27 patients were identified, with a median age of 61. 7 (25.9%) displayed electrographic seizures, and 3 (11.1%) displayed EEG patterns consistent with SE. The remaining 24 “non-SE” patients were hospitalized on average for 13.9 days after transfer, and 5.0 of those days (36%) were spent in the neurosurgical ICU. They underwent an average of 64.3 hours (SD 45.9) of CEEG monitoring during their hospital stay.

Conclusions Patients transferred for suspected SE often do not exhibit refractory seizure activity on CEEG after interhospital transfer, suggesting that transfer may not have provided clinical benefit. Improving access to routine EEG monitoring and/or remote EEG interpretation by epileptologists to rule out subclinical seizures may prevent unnecessary transfers, allocate tertiary care beds more efficiently, and allow patients to receive care closer to home.

Authors/Disclosures
Ian Cossentino, BS (Icahn School of Medicine at Mount Sinai) PRESENTER	No disclosure on file
Neha Dangayach, MD, F�鶹��ýӳ�� (Icahn School of Medicine At Mount Sinai and Mount Sinai Hospital)	Dr. Dangayach has nothing to disclose.
John Liang, MD (Mount Sinai Health System)	Dr. Liang has nothing to disclose.
	No disclosure on file
Alexandra S. Reynolds, MD	Dr. Reynolds has nothing to disclose.
Christopher P. Kellner, MD (Mount Sinai Health System)	Dr. Kellner has stock in METIS Innovative. Dr. Kellner has stock in Precision Recovery. Dr. Kellner has stock in Synchron. Dr. Kellner has stock in Fluid BioMed. Dr. Kellner has stock in Proprio. Dr. Kellner has stock in Von Vascular. Dr. Kellner has stock in E8. Dr. Kellner has stock in Borvo. Dr. Kellner has stock in Phantom Neuro. Dr. Kellner has stock in Radical. Dr. Kellner has stock in Reach Neuro. Dr. Kellner has stock in Aurenar. The institution of Dr. Kellner has received research support from Integra. The institution of Dr. Kellner has received research support from Penumbra. The institution of Dr. Kellner has received research support from Viz.AI. The institution of Dr. Kellner has received research support from ICE Neurosystems. The institution of Dr. Kellner has received research support from Irras. The institution of Dr. Kellner has received research support from Microtransponder. The institution of Dr. Kellner has received research support from Medtronic. The institution of Dr. Kellner has received research support from Longeviti. The institution of Dr. Kellner has received research support from Endostream. The institution of Dr. Kellner has received research support from CVAID.
Kaitlin Reilly-Kit, MD (Hackensack University Medical Center)	Dr. Reilly-Kit has nothing to disclose.
	No disclosure on file

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