title: ECT treatment outcomes following performance improvement changes.
abstract: Differences in electroconvulsive therapy (ECT) outcomes were explored following changes in ECT administration at our institution. Two changes were introduced: (a) switching the anesthetic agent from propofol to methohexital, and (b) using a more aggressive ECT charge dosing regimen for right unilateral (RUL) electrode placement. Length of stay (LOS) and number of treatments administered per patient were monitored. A retrospective analysis was performed of two inpatient groups treated on our Mood Disorders Unit: those who underwent ECT in the 12 months prior to the changes (n = 40) and those who underwent treatment in the 12 months after the changes (n = 38). Compared with patients receiving ECT with RUL placement prior to the changes, patients who received RUL ECT after the changes had a significantly shorter inpatient LOS (27.4 versus 18 days, p = 0.028). Treatment efficacy monitored by the Montgomery Asberg Depression Rating Scale was not impacted. The change in anesthetic agent and charge dosing each accounted for 11% of the variance in LOS among patients receiving RUL ECT. The implemented changes in ECT administration positively impacted outcome for patients receiving treatment with RUL electrode placement.
authors.forename: Kathy
authors.initials: K
authors.lastname: Pulia
authors.forename: Punit
authors.initials: P
authors.lastname: Vaidya
authors.forename: Geetha
authors.initials: G
authors.lastname: Jayaram
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Hayat
authors.forename: Irving M
authors.initials: IM
authors.lastname: Reti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000758:Anesthesia / Q000379:methods; D003863:Depression / Q000628:therapy; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult