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Continuous Electroencephalogram Use and Hospital Outcomes in Critically Ill Children
Ahyuda Oh1, Courtney J Wusthoff1,2, Hyunmi Kim1,2
1Departments of Neurology and Neurological Sciences; and.
Insights
Continuous EEG (CEEG) monitoring in critically ill children is linked to shorter hospital stays and reduced costs. However, it did not significantly improve overall discharge status, except in cases of seizures or status epilepticus.
Area of Science:
- Pediatric critical care medicine
- Neurocritical care
- Health services research
Background:
- Critically ill children often require continuous electroencephalogram (CEEG) monitoring for neurological assessment.
- Understanding the impact of CEEG on clinical outcomes and healthcare costs is crucial for resource allocation and patient management.
Purpose of the Study:
- To investigate the association between CEEG utilization and discharge status, length of hospitalization, and healthcare costs in critically ill children.
- To analyze the impact of CEEG in specific subgroups, including those with seizures, altered mental status, and cardiac arrest.
Main Methods:
- A retrospective analysis of 4,348 critically ill children from a US nationwide administrative health claims database (2015-2020).
- Comparison of discharge status, length of hospitalization, and healthcare costs between patients who underwent CEEG (n=212) and those who did not.
- Multiple logistic regression analysis controlling for age and neurological diagnosis; subgroup analyses were performed.
Main Results:
- Children undergoing CEEG had shorter hospital stays (OR=0.66) and lower hospitalization costs (OR=0.59) compared to non-CEEG patients.
- No significant difference in favorable discharge status was observed overall (OR=0.69).
- In the subgroup with seizures/status epilepticus, CEEG use was associated with a lower likelihood of unfavorable discharge (OR=0.51).
Conclusions:
- CEEG monitoring in critically ill children is associated with reduced hospital length of stay and lower healthcare costs.
- Overall favorable discharge status was not improved by CEEG, but it showed a benefit in children with seizures/status epilepticus.
- These findings suggest CEEG is a valuable tool for resource management and specific neurological conditions in pediatric critical care.
Purpose:
To examine the association between CEEG use and discharge status, length of hospitalization, and health care cost in a critically ill pediatric population.
Methods:
Four thousand three hundred forty-eight critically ill children were identified from a US nationwide administrative health claims database; 212 (4.9%) of whom underwent CEEG during admissions (January 1, 2015-june 30, 2020). Discharge status, length of hospitalization, and health care cost were compared between patients with and without CEEG use. Multiple logistic regression analyzed the association between CEEG use and these outcomes, controlling for age and underlying neurologic diagnosis. Prespecified subgroups analysis was performed for children with seizures/status epilepticus, with altered mental status and with cardiac arrest.
Results:
Compared with critically ill children without CEEG, those who underwent CEEG were likely to have shorter hospital stays than the median (OR = 0.66; 95% CI = 0.49-0.88; P = 0.004), and also total hospitalization costs were less likely to exceed the median (OR = 0.59; 95% CI = 0.45-0.79; P < 0.001). There was no difference in odds of favorable discharge status between those with and without CEEG (OR = 0.69; 95% CI = 0.41-1.08; P = 0.125). In the subgroup of children with seizures/status epilepticus, those with CEEG were less likely to have unfavorable discharge status, compared with those without CEEG (OR = 0.51; 95% CI = 0.27-0.89; P = 0.026).
Conclusions:
Among critically ill children, CEEG was associated with shorter stay and lower costs of hospitalization but was not associated with change of favorable discharge status except the subgroup with seizures/status epilepticus.
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