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EEG for good outcome prediction after cardiac arrest: A multicentre cohort study
Johannes Kepler Univ Linz, Austria; Lund Univ, Sweden.
Lund Univ, Sweden.
Lausanne Univ Hosp CHUV, Switzerland.
Oslo Univ Hosp, Norway.
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2024 (English)In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 202, article id 110319Article in journal (Refereed) Published
Abstract [en]

Aim: Assess the prognostic ability of a non-highly malignant and reactive EEG to predict good outcome after cardiac arrest (CA). Methods: Prospective observational multicentre substudy of the "Targeted Hypothermia versus Targeted Normothermia after Out-of-hospital Cardiac Arrest Trial", also known as the TTM2-trial. Presence or absence of highly malignant EEG patterns and EEG reactivity to external stimuli were prospectively assessed and reported by the trial sites. Highly malignant patterns were defined as burst-suppression or suppression with or without superimposed periodic discharges. Multimodal prognostication was performed 96 h after CA. Good outcome at 6 months was defined as a modified Rankin Scale score of 0-3. Results: 873 comatose patients at 59 sites had an EEG assessment during the hospital stay. Of these, 283 (32%) had good outcome. EEG was recorded at a median of 69 h (IQR 47-91) after CA. Absence of highly malignant EEG patterns was seen in 543 patients of whom 255 (29% of the cohort) had preserved EEG reactivity. A non-highly malignant and reactive EEG had 56% (CI 50-61) sensitivity and 83% (CI 80-86) specificity to predict good outcome. Presence of EEG reactivity contributed (p < 0.001) to the specificity of EEG to predict good outcome compared to only assessing background pattern without taking reactivity into account. Conclusion: Nearly one-third of comatose patients resuscitated after CA had a non-highly malignant and reactive EEG that was associated with a good long-term outcome. Reactivity testing should be routinely performed since preserved EEG reactivity contributed to prognostic performance.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD , 2024. Vol. 202, article id 110319
Keywords [en]
EEG; Reactivity; Prognosis; Coma; Cardiac arrest; Outcome
National Category
Anesthesiology and Intensive Care
Identifiers
URN: urn:nbn:se:liu:diva-207992DOI: 10.1016/j.resuscitation.2024.110319ISI: 001317342800001PubMedID: 39029579OAI: oai:DiVA.org:liu-207992DiVA, id: diva2:1903266
Note

Funding Agencies|Swedish Research Council; Swedish Heart-Lung Foundation; Knutsson Foundation, Laerdal Foundation; (Hans-Gabriel and Alice Trolle-Wachtmeister Foundation for Medical Research, and Regional Research Support in Region Skane); Laerdal Foundation; Hans-Gabriel and Alice Trolle-Wachtmeister Foundation for Medical Research; Regional Research Support in Region Skane; Swedish National Health Service

Available from: 2024-10-03 Created: 2024-10-03 Last updated: 2024-10-03

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Lindehammar, Hans
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The Division of Cell and NeurobiologyFaculty of Medicine and Health SciencesDepartment of Clinical Neurophysiology
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