Editors' note: Continuous EEG is associated with favorable hospitalization outcomes for critically ill patients

Abstract

In “Continuous EEG is associated with favorable hospitalization outcomes for critically ill patients,” Hill et al. retrospectively reviewed national inpatient hospitalization data over a 10-year period and found that continuous EEG (cEEG) use increased >10-fold from 2004 to 2013, but that it was still only used for 0.3% of critically ill patients. They noted that although patients evaluated with cEEG appeared more ill, its use was associated with lower in-hospital mortality for critically ill patients, prompting them to conclude that cEEG may be underused. At a single institution, Sethi found that cEEG use increased >5-fold from 2005 to 2011, but he notes that in some cases, cEEG was unnecessary, and a 30-minute emergent EEG would have been sufficient. He comments that better guidelines are needed on the indications for cEEG vs 30-minute EEG in critically ill patients. Hill et al. agree that it is necessary to further evaluate which subgroups of critically ill patients benefit from cEEG the most to ensure that resources are allocated appropriately. In “Patient-reported outcomes across cerebrovascular event types: More similar than different,” Katzan et al. retrospectively reviewed patient-reported measures in multiple domains over a 2-year period for 2,181 patients with ischemic stroke, TIA, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) at a single institution. After adjustment, patients with TIA had worse scores for pain, fatigue, anxiety, depression, and sleep than patients with the various forms of stroke. Spector notes that although the data for ischemic stroke, ICH, and SAH are interesting, the TIA results must be interpreted with caution because (1) there were no premorbid data on these domains, so it is unclear whether symptoms can be attributed to the TIA, and (2) some of the TIAs likely were not even ischemic. Katzan et al. agree with both of these limitations. Both Katzan et al. and Spector feel that further research of the impact of TIA on the aforementioned domains is needed.