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  1. Article ; Online: The New Era of Automated Electroencephalogram Interpretation.

    Kleen, Jonathan K / Guterman, Elan L

    JAMA neurology

    2023  Volume 80, Issue 8, Page(s) 777–778

    MeSH term(s) Humans ; Electroencephalography ; Image Interpretation, Computer-Assisted
    Language English
    Publishing date 2023-03-30
    Publishing country United States
    Document type Editorial ; Research Support, N.I.H., Extramural ; Comment
    ZDB-ID 2702023-X
    ISSN 2168-6157 ; 2168-6149
    ISSN (online) 2168-6157
    ISSN 2168-6149
    DOI 10.1001/jamaneurol.2023.1082
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Addressing Vulnerability and Dementia in the Era of COVID-19.

    Guterman, Elan L

    JAMA neurology

    2021  Volume 79, Issue 4, Page(s) 327–328

    MeSH term(s) COVID-19 ; Dementia/epidemiology ; Dementia/therapy ; Humans ; SARS-CoV-2
    Language English
    Publishing date 2021-11-08
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 2702023-X
    ISSN 2168-6157 ; 2168-6149
    ISSN (online) 2168-6157
    ISSN 2168-6149
    DOI 10.1001/jamaneurol.2021.5330
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  3. Article ; Online: Characterizing emergency department and inpatient health care utilization after seizure-related hospitalization: A retrospective cohort study.

    Johnson, Kristina L / Wood, Andrew J / Hsia, Renee Y / Guterman, Elan L

    Epilepsia

    2024  Volume 65, Issue 3, Page(s) 698–708

    Abstract: Objective: Seizure care is a significant driver of health care costs in both emergency department (ED) and inpatient settings, but the majority of studies have focused on inpatient admissions as the only metric of health care utilization. This study ... ...

    Abstract Objective: Seizure care is a significant driver of health care costs in both emergency department (ED) and inpatient settings, but the majority of studies have focused on inpatient admissions as the only metric of health care utilization. This study aims to better characterize ED and inpatient encounters among patients with seizure to inform care and policy.
    Methods: Using statewide administrative data from the Healthcare Cost and Utilization Project State Inpatient Databases and State Emergency Department Databases from Florida and New York, we identified patients with a seizure-related index hospitalization between January 1, 2016, and December 31, 2018. Among this cohort, we examined the incidence and characteristics of subsequent acute care visits in the ED and inpatient settings for 365 days after initial hospital discharge.
    Results: A total of 54 456 patients had an eligible seizure-related hospitalization. Patients were 49% female, predominantly White (64%) and non-Hispanic (84%), and used a public primary payer (68%). There were 36 838 (68%) patients with at least one acute care visit in the year following discharge. Overall, patients had a median of 2 (interquartile [IQR] = 1-5) subsequent acute care visits and the median time to first acute care visit was 53 days (IQR = 15-138). Of the 154 369 subsequent acute care visits, 97 399 (63%) were ED-only visits, 56 970 (37%) were readmissions, and 37 176 (24%) were seizure-related. There were 18 786 patients (35%) with four or more acute care visits over 365 days of follow-up. Patients with four or more visits contributed 84% of acute care visits and 78% of costs after initial hospitalization.
    Significance: The majority of patients hospitalized for seizure return to the ED or hospital at least once in the year after discharge. A small portion of patients account for the majority of ED and inpatient visits as well as health care costs associated with this population, identifying a subgroup of patients who may benefit from improved inpatient and outpatient management.
    MeSH term(s) Humans ; Female ; Male ; Retrospective Studies ; Inpatients ; Hospitalization ; Emergency Service, Hospital ; Health Care Costs ; Patient Acceptance of Health Care ; Seizures/epidemiology ; Seizures/therapy
    Language English
    Publishing date 2024-01-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 216382-2
    ISSN 1528-1167 ; 0013-9580
    ISSN (online) 1528-1167
    ISSN 0013-9580
    DOI 10.1111/epi.17878
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  4. Article ; Online: Seizing an Opportunity for Improvement.

    Guterman, Elan L / Lowenstein, Daniel H / Sporer, Karl A

    Neurology

    2021  Volume 98, Issue 7, Page(s) 287–288

    Language English
    Publishing date 2021-12-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 207147-2
    ISSN 1526-632X ; 0028-3878
    ISSN (online) 1526-632X
    ISSN 0028-3878
    DOI 10.1212/WNL.0000000000013248
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  5. Article ; Online: Hospital variation of outcomes in status epilepticus.

    Terman, Samuel W / Guterman, Elan L / Lin, Chun C / Thompson, Michael P / Burke, James F

    Epilepsia

    2024  

    Abstract: Objective: Understanding factors driving variation in status epilepticus outcomes would be critical to improve care. We evaluated the degree to which patient and hospital characteristics explained hospital-to-hospital variability in intubation and ... ...

    Abstract Objective: Understanding factors driving variation in status epilepticus outcomes would be critical to improve care. We evaluated the degree to which patient and hospital characteristics explained hospital-to-hospital variability in intubation and postacute outcomes.
    Methods: This was a retrospective cohort study of Medicare beneficiaries admitted with status epilepticus between 2009 and 2019. Outcomes included intubation, discharge to a facility, and 30- and 90-day readmissions and mortality. Multilevel models calculated percent variation in each outcome due to hospital-to-hospital differences.
    Results: We included 29 150 beneficiaries. The median age was 68 years (interquartile range [IQR] = 57-78), and 18 084 (62%) were eligible for Medicare due to disability. The median (IQR) percentages of each outcome across hospitals were: 30-day mortality 25% (0%-38%), any 30-day readmission 14% (0%-25%), 30-day status epilepticus readmission 0% (0%-3%), 30-day facility stay 40% (25%-53%), and intubation 46% (20%-61%). However, after accounting for many hospitals with small sample size, hospital-to-hospital differences accounted for 2%-6% of variation in all unadjusted outcomes, and approximately 1%-5% (maximally 8% for 30-day readmission for status epilepticus) after adjusting for patient, hospitalization, and/or hospital characteristics. Although many characteristics significantly predicted outcomes, the largest effect size was cardiac arrest predicting death (odds ratio = 10.1, 95% confidence interval = 8.8-11.7), whereas hospital characteristics (e.g., staffing, accreditation, volume, setting, services) all had lesser effects.
    Significance: Hospital-to-hospital variation explained little variation in studied outcomes. Rather, certain patient characteristics (e.g., cardiac arrest) had greater effects. Interventions to improve outcomes after status epilepticus may be better focused on individual or prehospital factors, rather than at the inpatient systems level.
    Language English
    Publishing date 2024-02-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 216382-2
    ISSN 1528-1167 ; 0013-9580
    ISSN (online) 1528-1167
    ISSN 0013-9580
    DOI 10.1111/epi.17927
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  6. Article: Impact of the COVID-19 Pandemic on Inpatient Utilization for Acute Neurologic Disease.

    Yoo, Alexander / Guterman, Elan L / Hwang, David Y / Holloway, Robert G / George, Benjamin P

    The Neurohospitalist

    2023  Volume 14, Issue 1, Page(s) 13–22

    Abstract: Background and Objective: ...

    Abstract Background and Objective:
    Language English
    Publishing date 2023-08-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2629083-2
    ISSN 1941-8752 ; 1941-8744
    ISSN (online) 1941-8752
    ISSN 1941-8744
    DOI 10.1177/19418744231196984
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  7. Article ; Online: Preprints During the COVID-19 Pandemic: Public Health Emergencies and Medical Literature.

    Guterman, Elan L / Braunstein, Lior Z

    Journal of hospital medicine

    2020  Volume 15, Issue 10, Page(s) 634–636

    MeSH term(s) Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Coronavirus Infections/therapy ; Emergencies ; Humans ; Information Dissemination/methods ; Pandemics ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/therapy ; Public Health/methods ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-09-23
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Review
    ZDB-ID 2233783-0
    ISSN 1553-5606 ; 1553-5592
    ISSN (online) 1553-5606
    ISSN 1553-5592
    DOI 10.12788/jhm.3491
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  8. Article ; Online: Status Epilepticus Mortality-Improving or Status Quo?

    Guterman, Elan L / Betjemann, John P

    JAMA neurology

    2019  Volume 76, Issue 8, Page(s) 885–886

    Language English
    Publishing date 2019-07-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2702023-X
    ISSN 2168-6157 ; 2168-6149
    ISSN (online) 2168-6157
    ISSN 2168-6149
    DOI 10.1001/jamaneurol.2019.0844
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  9. Article ; Online: Prehospital Treatment of Status Epilepticus in the United States.

    Guterman, Elan L / Burke, James F / Sporer, Karl A

    JAMA

    2021  Volume 326, Issue 19, Page(s) 1970–1971

    MeSH term(s) Anticonvulsants/administration & dosage ; Benzodiazepines/administration & dosage ; Diazepam/administration & dosage ; Emergency Medical Services ; Guideline Adherence/statistics & numerical data ; Humans ; Lorazepam/administration & dosage ; Midazolam/administration & dosage ; Practice Guidelines as Topic ; Status Epilepticus/drug therapy ; United States
    Chemical Substances Anticonvulsants ; Benzodiazepines (12794-10-4) ; Lorazepam (O26FZP769L) ; Diazepam (Q3JTX2Q7TU) ; Midazolam (R60L0SM5BC)
    Language English
    Publishing date 2021-11-16
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
    ISSN (online) 1538-3598
    ISSN 0254-9077 ; 0002-9955 ; 0098-7484
    DOI 10.1001/jama.2021.15964
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  10. Article ; Online: Management of Status Epilepticus and Indications for Inpatient Electroencephalography Monitoring.

    Fan, Joline M / Singhal, Neel S / Guterman, Elan L

    Neurologic clinics

    2021  Volume 40, Issue 1, Page(s) 1–16

    Abstract: Status epilepticus (SE) is a neurologic emergency requiring immediate time-sensitive treatment to minimize neuronal injury and systemic complications. Minimizing time to administration of first- and second-line therapy is necessary to optimize the ... ...

    Abstract Status epilepticus (SE) is a neurologic emergency requiring immediate time-sensitive treatment to minimize neuronal injury and systemic complications. Minimizing time to administration of first- and second-line therapy is necessary to optimize the chances of successful seizure termination in generalized convulsive SE (GCSE). The approach to refractory and superrefractory GCSE is less well defined. Multiple agents with differing complementary actions that facilitate seizure termination are recommended. Nonconvulsive SE (NCSE) has a wide range of presentations and approaches to treatment. Continuous electroencephalography is critical to the management of both GCSE and NCSE, while its use for patients without seizure continues to expand.
    MeSH term(s) Electroencephalography ; Humans ; Inpatients ; Monitoring, Physiologic ; Seizures ; Status Epilepticus/diagnosis ; Status Epilepticus/drug therapy
    Language English
    Publishing date 2021-11-08
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1013148-6
    ISSN 1557-9875 ; 0733-8619
    ISSN (online) 1557-9875
    ISSN 0733-8619
    DOI 10.1016/j.ncl.2021.08.001
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