Continuous EEG Is Associated With Favorable Hospitalization Outcomes for Critically Ill Patients. Hill CE, Blank LJ, Thibault D, et al. Willis Neurology. 2018. doi: https://doi.org/10.1212/WNL.0000000000006689 Objective: To characterize continuous electroencephalography (cEEG) use patterns in the critically ill and to determine the association with hospitalization outcomes for specific diagnoses. METHODS We performed a retrospective cross-sectional study with National Inpatient Sample data from 2004 to 2013. We sampled hospitalized adult patients who received intensive care and then compared patients who underwent cEEG to those who did not. We considered diagnostic subgroups of seizure/status epilepticus, subarachnoid or intracerebral hemorrhage, and altered consciousness. Outcomes were in-hospital mortality, hospitalization cost, and length of stay. RESULTS In total, 7 102 399 critically ill patients were identified, of whom 22 728 received cEEG. From 2004 to 2013, the proportion of patients who received cEEG increased from 0.06% (95% confidence interval [CI]: 0.03%-0.09%) to 0.80% (95% CI: 0.62%-0.98%). While the cEEG cohort appeared more ill, cEEG use was associated with reduced in-hospital mortality after adjustment for patient and hospital characteristics (odds ratio [OR]: 0.83, 95% CI: 0.75-0.93, P < .001). This finding held for the diagnoses of subarachnoid or intracerebral hemorrhage and for altered consciousness, but not for the seizure/status epilepticus subgroup. Cost and length of hospitalization were increased for the cEEG cohort (OR: 1.17 and 1.11, respectively, P < .001). CONCLUSIONS There was a >10-fold increase in cEEG use from 2004 to 2013. However, this procedure may still be underused; cEEG was associated with lower in-hospital mortality but used for only 0.3% of the critically ill population. While administrative claims analysis supports the utility of cEEG for critically ill patients, our findings suggest variable benefit by diagnosis, and investigation with greater clinical detail is warranted.

中文翻译：

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将脑电图带回未来：在神经重症监护中使用cEEG。

持续性脑电图与重症患者的良好住院结局相关。Hill CE，Blank LJ，Thibault D等。威利斯神经学。2018. doi：https://doi.org/10.1212/WNL.0000000000006689目标：表征重症患者的连续脑电图（cEEG）使用模式，并确定与特定诊断的住院结局的关系。方法我们对2004年至2013年的全国住院患者样本数据进行了回顾性横断面研究。我们对接受重症监护的住院成年患者进行了抽样，然后将接受cEEG的患者与未接受cEEG的患者进行了比较。我们考虑了癫痫发作/癫痫持续状态，蛛网膜下腔或脑出血的诊断亚组，以及意识改变。结果是院内死亡率，住院费用，和停留时间。结果总共确定了7102399例重症患者，其中22728例接受了cEEG。从2004年到2013年，接受cEEG的患者比例从0.06％（95％置信区间[CI]：0.03％-0.09％）增加到0.80％（95％CI：0.62％-0.98％）。尽管cEEG队列的病情较重，但在根据患者和医院的特点进行调整后，使用cEEG可以降低院内死亡率（赔率[OR]：0.83，95％CI：0.75-0.93，P <.001）。这一发现适用于蛛网膜下腔或脑出血的诊断和意识改变，但不适用于癫痫/癫痫持续状态亚组。cEEG队列的住院费用和住院时间增加（或：分别为1.17和1.11，P <.001）。结论从2004年到2013年，cEEG的使用增加了10倍以上。但是，此过程可能仍然没有得到充分利用。cEEG与降低院内死亡率有关，但仅用于危重人群的0.3％。尽管行政主张分析支持cEEG在重症患者中的实用性，但我们的发现表明，诊断可带来不同的益处，因此有必要进行更详细的临床研究。