Length of Stay in the Epilepsy Unit Utilizes Standardized Clinical Pathway

Background: Drug-resistant epilepsy defined as persistent seizures despite adequate doses of two appropriate first-line antiepileptic drugs (AED). Uncontrolled seizures cause injuries, disability, and increased mortality, thus surgery should be considered once the seizures are proven to be medically resistant. Surgical interventions may benefit patients (pts) with incomplete responses to AEDs after evaluation in the epilepsy monitoring unit (EMU) under video-EEG monitoring. Video-EEG monitoring in the epilepsy monitoring unit (EMU) is a limited clinical resource and availability of standardized units even scarcer. Knowledge of the preadmission predicting factors for length of stay (LOS) in the EMU may allow providers to utilize hospital resources and EMU beds more efficiently. Purpose: This study investigates the effect of patient-related variables, in-EMU -hospital stay for maximum EMU resource utilization. Methods: The records for all consecutive admissions to the EMU stay at King Faisal Specialist Hospital & Research Centre, between January 1, 2016 and December 31, 2016 will be reviewed retrospectively. Results: Our results about univariate analyses focusing on variables known before admission shows that EMU LOS (in days) was not significantly correlated with patient age, number of event types, or number of AEDs at admission. While the number of seizures recorded in EMU significantly correlated with age. Conclusion: Pre-admission clinical variables may predict EMU LOS. These factors could be used at the administrative level for maximum EMU resource utilization. The Clinical Pathway (CP) we established below is a general guideline and does not replace clinical judgment. Care should be individualized to meet the specific needs of each patient. The CP can, therefore, be deviated from when deemed appropriate with the reason documented.