Journal of Pediatric Neurology 2015; 13(02): 067-073
DOI: 10.1055/s-0035-1556767
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Procedure Use in Encephalitis, Epilepsy, and Meningitis: A Kids' Inpatient Database Study

Keith W. Pecor
1  Department of Biology, The College of New Jersey, Ewing, New Jersey, United States
,
Georges Bouobda Tsemo
2  City College, City University of New York, New York, United States
,
Nitin Agarwal
3  Department of Neurosciences and Neurology, Rutgers New Jersey Medical School, Newark, New Jersey, United States
,
Xue Ming
3  Department of Neurosciences and Neurology, Rutgers New Jersey Medical School, Newark, New Jersey, United States
› Author Affiliations
Further Information

Publication History

13 September 2014

10 November 2014

Publication Date:
07 August 2015 (online)

Abstract

For a given patient presentation, diagnostic procedure use can vary among clinicians, because certain procedures might pose risks or be viewed as more or less efficacious. We sought to determine which procedures were used most frequently in certain diagnoses (encephalitis, epilepsy, and meningitis) and whether or not those procedures were more successful in diagnosis than less commonly used procedures. In addition, we tested the hypothesis that procedure use would be affected by patient age and/or number of diagnoses. We used the kids' inpatient database to assess both the use and efficacy of selected procedures in the diagnosis of the aforementioned neurological conditions and variation in the number of procedures used based on age and number of diagnoses. Lumbar puncture and neuroimaging were the dominant procedures for encephalitis, and significantly, fewer procedures were used when lumbar puncture rather than neuroimaging was the principal procedure. Electroencephalography and neuroimaging were the dominant procedures for epilepsy/convulsions, but other procedures were equally efficacious. Lumbar puncture was the dominant procedure for meningitis, and significantly, fewer procedures were used when it was the principal procedure. Both age and number of diagnoses influenced the number of procedures used for encephalitis, whereas only number of diagnoses influenced number of procedures for epilepsy/convulsions. For meningitis, there was an interaction between age and number of diagnoses. While based on a sample of American patients, these results help us to better understand current diagnostic procedure use in general and can inform future use in all populations.