目的：我们为住院期间接受连续脑电图（cEEG）监测的患者的门诊护理提供了一个模型，急性后症状性癫痫（PASS）诊所。我们调查了建立该诊所是否可以改善癫痫专家的护理。
方法：作为PASS诊所计划的一部分，电子健康记录(EHR)向接受cEEG监测后首次服用抗癫痫药物(AED)的成人住院护理团队提供自动警报.该警报解释了基本原理，并有助于安排PASS诊所预约，出院后三个月，以及当天延长（75分钟）的脑电图。我们比较了2017年接受cEEG治疗的患者在EHR中启用警报之前（“PASS”期间和队列）和之后（“PASS”期间和队列）的初次癫痫临床就诊。
结果：在纳入的170例患者中，68（40％）在平均20.9±10个月的随访中癫痫发作。148名接受AED治疗的患者中有66名(44.6%)停止或减少了AED。PASS队列包括45名患者，而PASS队列中有145名患者。占患者的5.8%和9.9%，分别,在相应时期接受cEEG检查的患者(比值比[OR]=1.8，95%CI=1.26-2.54，P=.001)。这两个队列在电图或临床癫痫发作方面没有差异。PASS队列在出院后1-6个月内获得随访的可能性更大（OR=4.6，95％CI=2.1-10.1，P<.001），并且有临床前EEG（51.2％vs11.1％；OR=8.39，95％CI=3.1-22.67，P<.001）。
结论：PASS诊所，针对有急性症状性癫痫发作风险的患者,一种独特的门诊过渡护理模式导致获得癫痫专家的机会增加了近两倍.未来的研究应解决有关这些患者的最佳出院后管理实践的广泛知识差距。
OBJECTIVE: We present a model for the outpatient care of patients undergoing continuous electroencephalography (cEEG) monitoring during a hospitalization, named the post-acute symptomatic seizure (PASS) clinic. We investigated whether establishing this clinic led to improved access to epileptologist care.
METHODS: As part of the PASS clinic initiative, electronic health record (EHR) provides an automated alert to the inpatient care team discharging adults on first time antiepileptic drug (AED) after undergoing cEEG monitoring. The alert explains the rationale and facilitates scheduling for a PASS clinic appointment, three-month after discharge, along with a same-day extended (75 minutes) EEG. We compared the initial epilepsy clinic visits by patients undergoing cEEG in 2017, before (\"Pre-PASS\" period and cohort) and after (\"PASS\" period and cohort) the alert went live in the EHR.
RESULTS: Of the 170 patients included, 68 (40%) suffered a seizure during the mean follow-up of 20.9 ± 10 months. AEDs were stopped or reduced in 66 out of 148 (44.6%) patients discharged on AEDs. Pre-PASS cohort included 45 patients compared to 145 patients in the PASS cohort, accounting for 5.8% and 9.9% of patients, respectively, who underwent cEEG during the corresponding periods (odds ratio [OR] = 1.8, 95% CI = 1.26-2.54, P = .001). The two cohorts did not differ in terms of electrographic or clinical seizures. The PASS cohort was significantly more likely to be followed up within 1-6 months of discharge (OR = 4.6, 95% CI = 2.1-10.1, P < .001) and have a pre-clinic EEG (51.2% vs 11.1%; OR = 8.39, 95% CI = 3.1-22.67, P < .001).
CONCLUSIONS: PASS clinic, a unique outpatient transition of care model for managing patients at risk of acute symptomatic seizure led to an almost twofold increase in access to an epileptologist. Future research should address the wide knowledge gap about the best post-hospital discharge management practices for these patients.
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