Diagnostic value of electroencephalography inpatient patients: Effect on clinical decision-making Yatan hastalarda elektroensefalografinin tanısal değeri: Klinik karar verme üzerine etkisi

Abstract

© 2020, Istanbul Universitesi. All rights reserved.Objective: To evaluate the efficiency of electroencephalography (EEG) requested at the consul-tation. Methods: EEGs for which consultation was requested in one year were analyzed retrospectively. Neurology consultation notes, EEG forms, compliance with EEG findings were examined for each pa-tient. Demographic data, requested unit, pre-diagnosis, final diagnosis were recorded. EEG results were divided into 3 groups:1)normal, 2)EEG with epileptiform anomaly (EEG-EA),3)EEG with nonepilepti-form anomaly (EEG-NE). EEGs were also evaluated for their indications and contribution to diagnosis. Results: A total of 261 EEG recordings of 239 patients (133 men, average age 56.44 (18-90)) were examined. 30.5% of the registered patients had a history of neurological diseases. EEGs were requested from 36.4% intensive care units and emergency departments, 51.5% internal branches, 12.3% surgical branches. Preliminaries were seizures in 42.5%, alertness/encephalopathy in 17.2%, syncope in 5.7%, nonconvulsive status epilepticus (NCSE) in 10.3%. 55% of EEGs were considered nor-mal. 37.5% were in EEG-NE, 8.4% in EEG-EA. 91.6% of patients were imaged, 52.5% were pathological. Focal imaging pathology and EEG findings were compatible in 63% of patients with pathological EEG findings. EEG was pathological in 64.5% of the 127 patients requested with appropriate indications. 80% of EEG was thought not to contribute to the definitive diagnosis. Discussion: Male and advanced elderly people with neurological disease were preferred for EEG. Appropriate indication with a desired high probability of detection of pathological EEG. It is important that the doctor who evaluates the inpatient patient makes more careful decisions in terms of unneces-sary process, resource and time wasting.