Factors Contributing to the Length of Stay in Patients Admitted to the Epilepsy Monitoring Unit

Electroencephalography with video monitoring (VEEG) is considered the gold standard for differentiating epileptic from non-epileptic events. The standardization of length of hospital stay (LOS) in the Epilepsy Monitoring Unit (EMU) setting is challenging due to the paroxysmal nature of seizures. This study evaluates the factors contributing to the LOS and days of VEEG recording with the EMU final diagnosis and plan. A retrospective study was conducted on inpatients admitted to the EMU, at a tertiary center from January to December 2016. All consecutive patients admitted to EMU during the study period were included. A total of 160 patients were enrolled. The mean age was 21.10 years (SD 13.33). Upon discharge, most of the patients were diagnosed with epileptic seizures, of whom 91 (56.9%) had focal seizures, and 30 (18.8%) had generalized epilepsy. Patient who stayed in the EMU>12 days required 6-10 days of VEEG recording to reach the diagnosis. Patients who had the surgical plan as a discharge diagnosis were significant to have a prolonged length of stay>12 days. Six to ten days of EEG recording were significant to diagnose focal seizures in 44 (60.3%). Patients were concluded to have a surgical plan (resective surgery), focal seizures and Attention Deficit Hyperactivity Disorder (ADHD) as a comorbidity are all significantly associated with a prolonged length of stay. Our findings suggest that factors affecting the length of hospital stay or period of EEG recording during the admission should be considered when planning EMU admissions.