Safety of Video-EEG Monitoring from the National Inpatient Sample (IN5-1.008)

Abstract

Objective: To determine the rate of injuries and complications associated with prolonged videoEEG. Background VideoEEG monitoring is useful in the diagnosis and classification of epilepsy, diagnosis of non-epileptic seizures, and pre-surgical evaluation of medically intractable epilepsy by provoking events by reduction in anti-epileptic drugs and utilizing provocative measures. Risks of video-EEG monitoring include prolonged seizures, status epilepticus and risks associated with falls from seizures. Little data has been published on the frequency of adverse events occurring during video-EEG monitoring. Previous studies have looked a small numbers of patients at a single institution. Design/Methods: Retrospective cohort analysis of the NIS (ahrq.gov) a 20% stratified sample of all US hospital admissions from 1990 (first full year with ICD9 procedure code for videoEEG) through 2008. Elective admissions with a primary procedure videoEEG were selected using the ICD9 procedure code (8919). Other conditions and complications were determined using combination of ICD9 and Clinical Classification Software (CCS, AHRQ.gov) diagnostic codes. Comparison was made between admissions with a final diagnosis of epilepsy vs. nonepileptic events (NES). Because of multiple comparisons, p was set a priori at Results: 36,930 admissions were identified. Epilepsy was the final diagnosis in 86.56%. Urban teaching hospitals accounted for 91.15% of admissions. Status epilepticus occurred in 0.76%, deep vein thrombosis in 0.55%, urinary tract infection in 0.93%, pneumonia in 0.25%, fractures in 0.34% (there were no hip fractures), falls in 0.08% and depression in 6.69%. There were no cases of acute psychosis. There were no significant differences between those with epilepsy and NES. Conclusions: Over the 19 years examined prolonged videoEEG was quite safe. Rates of injuries and complications were lower than previously reported. Depression was the most frequent adverse event. Future studies should examine psychiatric complications of videoEEG monitoring. Disclosure: Dr. Hammond has nothing to disclose. Dr. Dubinsky has received personal compensation for activities with Allergan Pharmaceuticals as a speaker.Dr. Dubinsky has received research support from Allergan Pharmaceuticals, Medevation Pharmaceuticals, and NIH.