Pediatric Continuous EEG Monitoring Utilization: An 8-Year Cohort Study Using the Pediatric Health Information System...

Area of Science:

• Pediatric Neurology
• Critical Care Medicine
• Clinical Neurophysiology

Background:

• Continuous electroencephalography (CEEG) is recommended for critically ill neonates and children at risk for seizures.
• Understanding trends and variations in CEEG utilization is crucial for optimizing care.

Purpose of the Study:

• To evaluate trends in CEEG use over time.
• To assess variations in CEEG utilization based on patient and hospital factors for six common indications.

Main Methods:

• Retrospective cohort study using data from 40 children's hospitals (2016-2023).
• Defined six CEEG indications: neonatal hypoxic-ischemic encephalopathy (HIE), extracorporeal membrane oxygenation, cardiac arrest, stroke, traumatic brain injury, and neonates postcardiac surgery (post-CS).
• Analyzed associations between CEEG use and various patient/hospital factors using multivariable generalized linear models.

Main Results:

• CEEG use varied significantly by condition, ranging from 21% (TBI, post-CS) to 67% (HIE).
• CEEG utilization increased over time for extracorporeal membrane oxygenation, post-CS, and cardiac arrest.
• Younger age and higher medical complexity were associated with increased CEEG use; no consistent patterns were found for race, insurance, or Child Opportunity Index.

Conclusions:

• CEEG utilization has risen but remains inconsistent across different conditions and healthcare facilities.
• Leveraging existing variations in CEEG practices through comparative effectiveness research can help identify optimal strategies.