SHORT stays in pediatric epilepsy monitoring units (EMUs) achieve diagnostic goals in the majority of cases, with drug-resistant epilepsy emerging as a key predictor of both success and repeat admissions, according to a retrospective analysis of 462 admissions over a 10-year period.
The study focused on patients admitted to the pediatric EMU at CHEO between 2014 and 2024, all of whom had stays of four days or fewer. Researchers found that 82.0% of these short EMU admissions successfully met their diagnostic or treatment objectives. Despite the brevity of these stays, they were effective in guiding management decisions for most pediatric patients with epilepsy.
A notable finding was the association between drug-resistant epilepsy and admission outcomes. Patients with a known diagnosis of drug-resistant epilepsy were significantly more likely to achieve their EMU goals during a short stay (OR = 2.2, 95% CI: 1.3–3.7). However, this same group also showed a higher likelihood of requiring repeat EMU admissions over time (OR = 4.2, 95% CI: 2.4–7.6), even after adjusting for seizure type, admission goals, medication weaning, age, and gender.
Interestingly, seizure type, whether focal, generalized, or both, did not influence the likelihood of either a successful admission or the need for a repeat visit. Overall, just under a quarter of all EMU admissions were repeat evaluations, emphasizing the importance of tailored care pathways for complex epilepsy cases.
These findings suggest that short EMU stays are often sufficient for initial assessment and decision-making, especially for patients with drug-resistant epilepsy. However, providers should anticipate that this population may need additional admissions. Understanding these patterns can help optimize EMU scheduling and resource allocation, reducing strain on high-demand pediatric epilepsy services.
The data offer a framework for physicians to better plan monitoring strategies and set realistic expectations for families, particularly in cases involving complex epilepsy management.
Reference:
Chahrour M et al. Healthcare utilization in drug-resistant epilepsy: A retrospective cohort study into factors predictive of success during short pediatric EMU admissions. Epileptic Disord. 2025. doi:10.1002/epd2.70060.
