Pediatric Continuous EEG Monitoring Utilization: An 8-Year Cohort Study Using the Pediatric Health Information System Database.
Publication/Presentation Date
7-24-2026
Abstract
PURPOSE: Continuous electroencephalography (CEEG) is recommended in critically ill neonates and children at risk for experiencing seizures. Its utilization across time and conditions remains unclear. We evaluated trends in CEEG use and variation based on patient and hospital level factors for six common indications.
METHODS: This retrospective cohort study queried data from 40 children's hospitals in the Pediatric Health Information Systems database from January 2016 to December 2023. Using ICD-10 diagnosis codes, we defined six CEEG indications: neonatal hypoxic-ischemic encephalopathy (HIE), extracorporeal membrane oxygenation, cardiac arrest, stroke, traumatic brain injury, and neonates postcardiac surgery (post-CS). CEEG utilization was assessed annually. Associations between CEEG utilization and year, age, sex, race, history of seizures or epilepsy, medical complexity, payer, hospital region, and the Child Opportunity Index (COI) were evaluated in unadjusted ORs and an adjusted OR (aOR) in a multivariable generalized linear model.
RESULTS: CEEG use varied by condition: neonatal HIE 67%, extracorporeal membrane oxygenation 47%, cardiac arrest 39%, stroke 36%, traumatic brain injury 21%, and post-CS 21%. CEEG use increased over the study period for extracorporeal membrane oxygenation (aOR 4.65; 2.47-8.77; P < 0.001), post-CS (aOR 3.5; 1.36-8.99; P = 0.009), and cardiac arrest (aOR 1.95; 95% CI 1.22-3.12; P = 0.005). CEEG use varied by hospital and condition. Younger age and increased medical complexity were associated with higher odds of CEEG. There was no consistent pattern of CEEG variation by race, ethnicity, insurance type, or COI, although condition specific differences were present.
CONCLUSIONS: CEEG utilization has increased over time but remains variable across hospitals and indications. Comparative effectiveness approaches that leverage variation could determine optimal CEEG practices.
ISSN
1537-1603
Published In/Presented At
Fitts, W., Press, C., Zaniletti, I., Benedetti, G. M., Nash, K., Wells, E. M., Messer, R., Palaganas, J., Moharir, M., Piantino, J., Kirschen, M., Appavu, B., Abend, N. S., & Pediatric Neurohospitalist Working Group (2026). Pediatric Continuous EEG Monitoring Utilization: An 8-Year Cohort Study Using the Pediatric Health Information System Database. Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society, 10.1097/WNP.0000000000001287. Advance online publication. https://doi.org/10.1097/WNP.0000000000001287
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
42519975
Department(s)
Department of Pediatrics
Document Type
Article