EEG Pattern With Spectral Analysis Can Prognosticate Good and Poor Neurologic Outcomes After Cardiac Arrest

被引:0
作者
Qing, Kurt Y. [1 ,2 ]
Forgacs, Peter B. [1 ]
Schiff, Nicholas D. [1 ]
机构
[1] Weill Cornell Med Ctr, Dept Neurol, New York Presbyterian, New York, NY USA
[2] Stanford Univ, Dept Neurol, 213 Quarry Rd, Palo Alto, CA 94304 USA
关键词
Postcardiac arrest prognostication; EEG; Quantitative EEG; QUALITY-OF-LIFE; REGIONAL-VARIATION; STATUS EPILEPTICUS; SURVIVORS; RECOVERY;
D O I
10.1097/WNP.0000000000000958
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Supplemental Digital Content is Available in the Text. Purpose:To investigate the prognostic value of a simple stratification system of electroencephalographical (EEG) patterns and spectral types for patients after cardiac arrest.Methods:In this prospectively enrolled cohort, using manually selected EEG segments, patients after cardiac arrest were stratified into five independent EEG patterns (based on background continuity and burden of highly epileptiform discharges) and four independent power spectral types (based on the presence of frequency components). The primary outcome is cerebral performance category (CPC) at discharge. Results from multimodal prognostication testing were included for comparison.Results:Of a total of 72 patients, 6 had CPC 1-2 by discharge, all of whom had mostly continuous EEG background without highly epileptiform activity at day 3. However, for the same EEG background pattern at day 3, 19 patients were discharged at CPC 3 and 15 patients at CPC 4-5. After adding spectral analysis, overall sensitivity for predicting good outcomes (CPC 1-2) was 83.3% (95% confidence interval 35.9% to 99.6%) and specificity was 97.0% (89.5% to 99.6%). In this cohort, standard prognostication testing all yielded 100% specificity but low sensitivity, with imaging being the most sensitive at 54.1% (36.9% to 70.5%).Conclusions:Adding spectral analysis to qualitative EEG analysis may further improve the diagnostic accuracy of EEG and may aid developing novel measures linked to good outcomes in postcardiac arrest coma.
引用
收藏
页码:236 / 244
页数:9
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