The prognostic value of discontinuous EEG patterns in postanoxic coma

Barry J. Ruijter* (Corresponding Author), Jeannette Hofmeijer, Marleen C. Tjepkema-Cloostermans, Michel J.A.M. van Putten

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

11 Citations (Scopus)
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Abstract

Objective: To assess the value of background continuity and amplitude fluctuations of the EEG for the prediction of outcome of comatose patients after cardiac arrest. Methods: In a prospective cohort study, we analyzed EEGs recorded in the first 72 h after cardiac arrest. We defined the background continuity index (BCI) as the fraction of EEG not spent in suppressions (amplitudes < 10 µV for ≥ 0.5 s), and the burst-suppression amplitude ratio (BSAR) as the mean amplitude ratio between non-suppressed and suppressed segments. Outcome was assessed at 6 months and categorized as “good” (Cerebral Performance Category 1–2) or “poor” (CPC 3–5). Results: Of the 559 patients included, 46% had a good outcome. Combinations of BCI and BSAR resulted in the highest prognostic accuracies. Good outcome could be predicted at 24 h with 57% sensitivity (95% confidence interval (CI): 48–67) at 90% specificity (95%-CI: 86–95). Poor outcome could be predicted at 12 h with 50% sensitivity (95%-CI: 42–56) at 100% specificity (95%-CI: 99–100). Conclusions: EEG background continuity and the amplitude ratio between bursts and suppressions reliably predict the outcome of postanoxic coma. Significance: The presented features provide an objective, rapid, and reliable tool to assist in EEG interpretation in the Intensive Care Unit.

Original languageEnglish
Pages (from-to)1534-1543
Number of pages10
JournalClinical neurophysiology
Volume129
Issue number8
DOIs
Publication statusPublished - 1 Aug 2018

Keywords

  • Background continuity
  • Burst-suppression
  • Electroencephalography
  • Generalized periodic discharges
  • Postanoxic encephalopathy
  • Quantitative EEG

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