OBJECTIVE The clinical implementation of continuous electroencephalography (CEEG) monitoring in critically ill patients is hampered by the substantial burden of work that it entails for clinical neurophysiologists. Solutions that might reduce this burden, including by shortening the duration of EEG to be recorded, would help its widespread adoption. Our aim was to validate a recently described algorithm of time-dependent electro-clinical risk stratification for electrographic seizure (ESz) (TERSE) based on simple clinical and EEG features. METHODS We retrospectively reviewed the medical records and EEG recordings of consecutive patients undergoing CEEG between October 1, 2015 and September, 30 2016 and assessed the sensitivity of TERSE for seizure detection, as well as the reduction in EEG time needed to be reviewed. RESULTS In a cohort of 407 patients and compared to full CEEG review, the model allowed the detection of 95% of patients with ESz and 97% of those with electrographic status epilepticus. The amount of CEEG to be recorded to detect ESz was reduced by two-thirds, compared to the duration of CEEG taht was actually recorded. CONCLUSIONS TERSE allowed accurate time-dependent ESz risk stratification with a high sensitivity for ESz detection, which could substantially reduce the amount of CEEG to be recorded and reviewed, if applied prospectively in clinical practice. SIGNIFICANCE Time-dependent electro-clinical risk stratification, such as TERSE, could allow more efficient practice of CEEG and its more widespread adoption. Future studies should aim to improve risk stratification in the subgroup of patients with acute brain injury and absence of clinical seizures.

中文翻译：

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危重患者脑电图癫痫 (TERSE) 时间依赖性电临床风险分层算法的验证

目标连续脑电图 (CEEG) 监测在危重患者中的临床实施受到临床神经生理学家的巨大工作负担的阻碍。可能减轻这种负担的解决方案，包括缩短记录 EEG 的持续时间，将有助于其广泛采用。我们的目标是验证最近描述的基于简单临床和 EEG 特征的脑电图癫痫 (ESz) (TERSE) 时间相关电临床风险分层算法。方法 我们回顾性地回顾了 2015 年 10 月 1 日至 2016 年 9 月 30 日期间接受 CEEG 的连续患者的医疗记录和脑电图记录，并评估了 TERSE 对癫痫发作检测的敏感性，以及需要审查的脑电图时间的减少。结果 在 407 名患者的队列中，与完整的 CEEG 审查相比，该模型允许检测 95% 的 ESz 患者和 97% 的癫痫持续状态患者。与实际记录的 CEEG 持续时间相比，用于检测 ESz 的 CEEG 数量减少了三分之二。结论 TERSE 允许准确的时间依赖性 ESz 风险分层，对 ESz 检测具有高灵敏度，如果在临床实践中前瞻性应用，这可以显着减少记录和审查的 CEEG 数量。意义 与时间相关的电临床风险分层，如 TERSE，可以允许更有效的 CEEG 实践及其更广泛的采用。