naa a22 4500 510799582 CHVBK 20180411083349.0 cr unu---uuuuu 180411e20131201xx s 000 0 eng 10.1007/s12028-012-9736-7 doi (NATIONALLICENCE)springer-10.1007/s12028-012-9736-7 Diagnostic Yield of Electroencephalography in the Medical and Surgical Intensive Care Unit [Elektronische Daten] [Hooman Kamel, John Betjemann, Babak Navi, Manu Hegde, Karl Meisel, Vanja Douglas, S. Josephson] Background: To determine the incidence of electrographic seizures during continuous electroencephalography (cEEG) in the medical and surgical ICU. Methods: We retrospectively reviewed the records of all adults who underwent cEEG in our medical and surgical ICU over a 4.5year period. Patients with acute brain injury were excluded. Our primary outcome was cEEG documentation of an electrographic seizure, defined as a rhythmic discharge or spike and wave pattern demonstrating definite evolution and lasting at least 10s. To assess inter-rater variability in cEEG interpretation, two electrophysiologists independently reviewed all available cEEGs of subjects with electrographic seizures documented on their clinical cEEG report and those of an equal number of randomly selected subjects from the remaining cohort. Results: Kappa analysis showed a value of 0.88, indicating excellent inter-rater agreement. Electrographic seizures were identified in 12 of 105 patients (11%, 95% CI 5-18%). This rate did not change after excluding patients with a history of seizure, remote brain injury, or seizure-like events before cEEG. In an ordinal logistic regression model controlling for age, sex, and SOFA score, electrographic seizures were associated with lower odds of good outcomes on the Glasgow Outcome Scale at discharge (OR 0.3, 95% CI 0.1-0.8). Conclusion: In a tertiary care medical and surgical ICU, electrographic seizures were seen on 11% of cEEGs ordered for the evaluation of encephalopathy, and were associated with worse functional outcomes at discharge. Our findings confirm the results of a prior study suggesting a substantial burden of electrographic seizures in critically ill encephalopathic patients. Springer Science+Business Media, LLC, 2012 Encephalopathy nationallicence Intensive care unit nationallicence Seizure nationallicence Status epilepticus nationallicence Electroencephalography nationallicence Kamel Hooman Department of Neurology and Neuroscience, Weill Cornell Medical College, 525 East 68th St, F610, 10065, New York, NY, USA aut Betjemann John Department of Neurology, University of California, San Francisco, USA aut Navi Babak Department of Neurology and Neuroscience, Weill Cornell Medical College, 525 East 68th St, F610, 10065, New York, NY, USA aut Hegde Manu Department of Neurology, University of California, San Francisco, USA aut Meisel Karl Department of Neurology, University of California, San Francisco, USA aut Douglas Vanja Department of Neurology, University of California, San Francisco, USA aut Josephson S. Department of Neurology, University of California, San Francisco, USA aut Neurocritical Care Springer US; http://www.springer-ny.com 19/3(2013-12-01), 336-341 1541-6933 19:3<336 2013 19 12028 https://doi.org/10.1007/s12028-012-9736-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-012-9736-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kamel Hooman Department of Neurology and Neuroscience, Weill Cornell Medical College, 525 East 68th St, F610, 10065, New York, NY, USA aut NATIONALLICENCE 700 1- Betjemann John Department of Neurology, University of California, San Francisco, USA aut NATIONALLICENCE 700 1- Navi Babak Department of Neurology and Neuroscience, Weill Cornell Medical College, 525 East 68th St, F610, 10065, New York, NY, USA aut NATIONALLICENCE 700 1- Hegde Manu Department of Neurology, University of California, San Francisco, USA aut NATIONALLICENCE 700 1- Meisel Karl Department of Neurology, University of California, San Francisco, USA aut NATIONALLICENCE 700 1- Douglas Vanja Department of Neurology, University of California, San Francisco, USA aut NATIONALLICENCE 700 1- Josephson S. Department of Neurology, University of California, San Francisco, USA aut NATIONALLICENCE 773 0- Neurocritical Care Springer US; http://www.springer-ny.com 19/3(2013-12-01), 336-341 1541-6933 19:3<336 2013 19 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer