Dataset Information

Standardized EEG interpretation accurately predicts prognosis after cardiac arrest.

ABSTRACT:

Objective

To identify reliable predictors of outcome in comatose patients after cardiac arrest using a single routine EEG and standardized interpretation according to the terminology proposed by the American Clinical Neurophysiology Society.

Methods

In this cohort study, 4 EEG specialists, blinded to outcome, evaluated prospectively recorded EEGs in the Target Temperature Management trial (TTM trial) that randomized patients to 33°C vs 36°C. Routine EEG was performed in patients still comatose after rewarming. EEGs were classified into highly malignant (suppression, suppression with periodic discharges, burst-suppression), malignant (periodic or rhythmic patterns, pathological or nonreactive background), and benign EEG (absence of malignant features). Poor outcome was defined as best Cerebral Performance Category score 3-5 until 180 days.

Results

Eight TTM sites randomized 202 patients. EEGs were recorded in 103 patients at a median 77 hours after cardiac arrest; 37% had a highly malignant EEG and all had a poor outcome (specificity 100%, sensitivity 50%). Any malignant EEG feature had a low specificity to predict poor prognosis (48%) but if 2 malignant EEG features were present specificity increased to 96% (p < 0.001). Specificity and sensitivity were not significantly affected by targeted temperature or sedation. A benign EEG was found in 1% of the patients with a poor outcome.

Conclusions

Highly malignant EEG after rewarming reliably predicted poor outcome in half of patients without false predictions. An isolated finding of a single malignant feature did not predict poor outcome whereas a benign EEG was highly predictive of a good outcome.

SUBMITTER: Westhall E

PROVIDER: S-EPMC4836886 | biostudies-literature | 2016 Apr

REPOSITORIES: biostudies-literature

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Publications

Standardized EEG interpretation accurately predicts prognosis after cardiac arrest.

Westhall Erik E Rossetti Andrea O AO van Rootselaar Anne-Fleur AF Wesenberg Kjaer Troels T Horn Janneke J Ullén Susann S Friberg Hans H Nielsen Niklas N Rosén Ingmar I Åneman Anders A Erlinge David D Gasche Yvan Y Hassager Christian C Hovdenes Jan J Kjaergaard Jesper J Kuiper Michael M Pellis Tommaso T Stammet Pascal P Wanscher Michael M Wetterslev Jørn J Wise Matt P MP Cronberg Tobias T

Neurology 20160210 16

<h4>Objective</h4>To identify reliable predictors of outcome in comatose patients after cardiac arrest using a single routine EEG and standardized interpretation according to the terminology proposed by the American Clinical Neurophysiology Society.<h4>Methods</h4>In this cohort study, 4 EEG specialists, blinded to outcome, evaluated prospectively recorded EEGs in the Target Temperature Management trial (TTM trial) that randomized patients to 33°C vs 36°C. Routine EEG was performed in patients s ...[more]

PMID: 26865516

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Dataset Information

Standardized EEG interpretation accurately predicts prognosis after cardiac arrest.

Objective

Methods

Results

Conclusions

Publications

Standardized EEG interpretation accurately predicts prognosis after cardiac arrest.

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