The role of cEEG as a predictor of patient outcome and survival in patients with intraparenchymal hemorrhages

Purpose: The objective of this study was to determine if continuous electroencephalography (cEEG) results are associated with functional outcome and survival in critically ill patients with intraparenchymal hemorrhages (IPH). Methods: Patients diagnosed with IPH were selected using a Critical Care EEG Monitoring Consortium Database at Brigham and Women's Hospital in Boston. Functional Outcome in Patients with Primary Intracerebral Hemorrhage (FUNC) scores and Intracerebral Hemorrhage (ICH) scores were calculated as covariates. Outcomes of interest were functional outcome (modified Rankin scale [mRS] < 3 vs >= 3) and mortality at hospital discharge. cEEG features, as defined by the American Clinical Neurophysiology Society standard terminology, were assessed for association with outcome after accounting for known clinical covariates. Results: A total of 94 patients admitted between March 2013 and December 2015 were selected. Multivariate regression analysis revealed that the presence of Stage II Sleep is independently associated with good functional outcome at discharge after correcting for FUNC (p = 0.0080) and ICH (p = 0.0088). The absence of anteroposterior (AP) gradient in an EEG is associated with increased likelihood of mortality at discharge after correcting for FUNC (p = 0.013) and ICH (p = 0.019) scores. Conclusions: cEEG measures were significantly associated with functional and mortality outcome measures in patients with IPH even after accounting for known clinical and radiological covariates. Further research is needed to determine whether prediction models are improved by inclusion of cEEG features.