title: Epilepsy monitoring unit length of stay.
abstract: With an increasing focus on quality metrics, hospital length of stay (LOS) in the U.S. has garnered significant scrutiny. To help establish evidence-based benchmarks for epilepsy monitoring unit (EMU) metrics, we evaluated the impact of multiple variables on LOS through a retrospective analysis of 905 consecutive inpatient adult EMU admissions. The most common reasons for admission were event characterization (n=494), medication adjustment (n=189), and presurgical evaluation (n=96). Presurgical evaluations experienced a longer average LOS (aLOS) of 7.1days versus patients admitted for other indications (p<0.001). Patients with symptomatic generalized epilepsy (n=22) had a longer aLOS (6.9days) than patients with other types of epilepsy/events (p<0.001). Patients admitted on two or fewer antiepileptic drugs (AEDs) had a shorter aLOS than patients admitted on three or more AEDs (4.3days vs 6.3days, respectively; p<0.001). A history of previous invasive epilepsy management was associated with a longer aLOS than those without (6.2days vs 4.7days, respectively; p<0.0001). Epilepsy monitoring unit aLOS is influenced by admission indication, epilepsy classification, medication burden, and having had prior invasive management. Multiple variables should be considered when analyzing LOS EMU metrics, arguing against a "one size fits all" approach.
authors.affiliation: New York University Langone Medical Center, USA. Electronic address: Deana.Gazzola@nyumc.org.
authors.forename: Deana M
authors.initials: DM
authors.lastname: Gazzola
authors.affiliation: New York University Langone Medical Center, USA.
authors.forename: Sujata
authors.initials: S
authors.lastname: Thawani
authors.affiliation: New York University Langone Medical Center, USA.
authors.forename: Olanrewaju
authors.initials: O
authors.lastname: Agbe-Davies
authors.affiliation: New York University Langone Medical Center, USA; Medical College of Wisconsin, USA.
authors.forename: Chad
authors.initials: C
authors.lastname: Carlson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use; D004569:Electroencephalography / Q000379:methods / Q000639:trends*; D004827:Epilepsy / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D006760:Hospitalization / Q000639:trends; D006801:Humans; D007902:Length of Stay / Q000639:trends*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods / Q000639:trends*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Epilepsy monitoring unit; Length of stay; Quality metrics; Video-EEG monitoring