Real-World Continuous EEG Utilization and Outcomes in Hospitalized Patients With Acute Cerebrovascular Diseases

Area of Science:

• Neurology
• Critical Care Medicine
• Health Services Research

Background:

• Continuous electroencephalography (cEEG) is recommended for hospitalized patients with cerebrovascular diseases experiencing seizures or unexplained neurological decline.
• Current utilization patterns and impact on outcomes require further investigation.

Purpose of the Study:

• To identify practice variations in cEEG utilization among patients with cerebrovascular diseases.
• To determine predictors associated with cEEG use.
• To evaluate the association between cEEG utilization and in-hospital mortality.

Main Methods:

• A retrospective cohort study analyzed over 1.1 million hospital admissions from the Premier Healthcare Database (2014-2020).
• Patients >18 years with cerebrovascular diseases were identified using ICD codes.
• Multivariable logistic regression and propensity score-matched analysis assessed predictors of cEEG use and its association with mortality.

Main Results:

• Only 1.4% of eligible admissions (16,777/1,179,471) underwent cEEG, despite a 364% national increase over five years.
• Predictors of cEEG use included seizure diagnosis, larger hospital size, and specific US regions.
• Propensity analysis indicated cEEG use was associated with a significant reduction in in-hospital mortality (OR 0.746).

Conclusions:

• National cEEG utilization for hospitalized cerebrovascular disease patients is increasing but shows significant practice variation.
• cEEG use is associated with improved in-hospital survival.
• Further research and guidelines are needed to optimize cEEG access and application in clinical practice.