Development and Feasibility Testing of a Critical Care EEG Monitoring Database for Standardized Clinical Reporting and Multicenter Collaborative Research

Abstract

Purpose: The rapid expansion of the use of continuous critical care electroencephalogram (cEEG) monitoring and resulting multicenter research studies through the Critical Care EEG Monitoring Research Consortium has created the need for a collaborative data sharing mechanism and repository. The authors describe the development of a research database incorporating the American Clinical Neurophysiology Society standardized terminology for critical care EEG monitoring. The database includes flexible report generation tools that allow for daily clinical use.

Methods: Key clinical and research variables were incorporated into a Microsoft Access database. To assess its utility for multicenter research data collection, the authors performed a 21-center feasibility study in which each center entered data from 12 consecutive intensive care unit monitoring patients. To assess its utility as a clinical report generating tool, three large volume centers used it to generate daily clinical critical care EEG reports.

Results: A total of 280 subjects were enrolled in the multicenter feasibility study. The duration of recording (median, 25.5 hours) varied significantly between the centers. The incidence of seizure (17.6%), periodic/rhythmic discharges (35.7%), and interictal epileptiform discharges (11.8%) was similar to previous studies. The database was used as a clinical reporting tool by 3 centers that entered a total of 3,144 unique patients covering 6,665 recording days.

Conclusions: The Critical Care EEG Monitoring Research Consortium database has been successfully developed and implemented with a dual role as a collaborative research platform and a clinical reporting tool. It is now available for public download to be used as a clinical data repository and report generating tool.

FIG. 1

Database user interface: demographics, clinical, and technical information entry screen.

FIG. 2

Database user interface: EEG results entry screen: (A) background; (B) seizures, interictal discharges, rhythmic/periodic patterns, others.

FIG. 3

Indication for critical care EEG monitoring in 280 consecutive patients from 21 participating Critical Care EEG Monitoring Research Consortium centers. AMS, altered mental status; HIE, hypoxic ischemic encephalopathy; ICH, intracranial hemorrhage; IVH, intraventricular hemorrhage; Met. Encephalopathy, metabolic encephalopathy; SAH, subarachnoid hemorrhage; SDH, subdural hemorrhage; SVT, sinus venous thrombosis; TBI, traumatic brain injury.

FIG. 4

Location of critical care EEG monitoring among participating Critical Care EEG Monitoring Research Consortium centers. MICU, medical intensive care unit; NICU, neonatal intensive care unit; PICU, pediatric intensive care unit; SICU, surgical intensive care unit.

FIG. 5

Duration of EEG monitoring among participating Critical Care EEG Monitoring Research Consortium centers (numbers assigned at random). Red stars represent the median duration of monitoring.