Stimulus-induced EEG-patterns and outcome after cardiac arrest
(2021) In Clinical Neurophysiology Practice 6. p.219-224- Abstract
Objective: EEG is commonly used to predict prognosis in post anoxic coma. We investigated if stimulus-induced rhythmic, periodic or ictal discharges (SIRPIDs) add prognostic information after cardiac arrest. Methods: In the multicenter Targeted Temperature Management trial, routine-EEGs were prospectively recorded after rewarming (≥36 h). Presence and subtype of SIRPIDs and main EEG-pattern (benign, malignant, highly malignant) were retrospectively reported according to a standardised classification. Patients were followed up after 180 days. Poor outcome was defined as severe neurological disability or death (Cerebral Performance Category 3–5). Results: Of 142 patients, 71% had poor outcome and 14% had SIRPIDs. There was no significant... (More)
Objective: EEG is commonly used to predict prognosis in post anoxic coma. We investigated if stimulus-induced rhythmic, periodic or ictal discharges (SIRPIDs) add prognostic information after cardiac arrest. Methods: In the multicenter Targeted Temperature Management trial, routine-EEGs were prospectively recorded after rewarming (≥36 h). Presence and subtype of SIRPIDs and main EEG-pattern (benign, malignant, highly malignant) were retrospectively reported according to a standardised classification. Patients were followed up after 180 days. Poor outcome was defined as severe neurological disability or death (Cerebral Performance Category 3–5). Results: Of 142 patients, 71% had poor outcome and 14% had SIRPIDs. There was no significant difference in outcome between patients with and without SIRPIDs, even when subgrouped according to underlying main EEG-pattern. Comparing subtypes of SIRPIDs, 82% of patients with stimulus-induced periodic discharges had poor outcome compared to 44% of patients with stimulus-induced rhythmic delta activity, but the difference was not significant. Conclusions: In EEGs performed ≥36 h after cardiac arrest, SIRPIDs cannot be used to reliably predict poor outcome. Whether certain subtypes of SIRPIDs indicate worse prognosis needs further investigation. Significance: Categorising the main EEG-pattern has important prognostic implications, but assessment of late appearing SIRPIDs does not seem to add prognostic information.
(Less)
- author
- Broman, N. Jaffer ; Backman, S. LU and Westhall, E. LU
- organization
- publishing date
- 2021-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cardiac arrest, Coma, EEG, Prognosis, SIRPIDs
- in
- Clinical Neurophysiology Practice
- volume
- 6
- pages
- 6 pages
- publisher
- Elsevier
- external identifiers
-
- pmid:34401610
- scopus:85111890159
- ISSN
- 2467-981X
- DOI
- 10.1016/j.cnp.2021.07.001
- language
- English
- LU publication?
- yes
- id
- 32815a47-2f5d-44d8-8274-9dd146b3deb4
- date added to LUP
- 2021-12-21 15:49:35
- date last changed
- 2024-06-15 23:09:10
@article{32815a47-2f5d-44d8-8274-9dd146b3deb4,
abstract = {{<p>Objective: EEG is commonly used to predict prognosis in post anoxic coma. We investigated if stimulus-induced rhythmic, periodic or ictal discharges (SIRPIDs) add prognostic information after cardiac arrest. Methods: In the multicenter Targeted Temperature Management trial, routine-EEGs were prospectively recorded after rewarming (≥36 h). Presence and subtype of SIRPIDs and main EEG-pattern (benign, malignant, highly malignant) were retrospectively reported according to a standardised classification. Patients were followed up after 180 days. Poor outcome was defined as severe neurological disability or death (Cerebral Performance Category 3–5). Results: Of 142 patients, 71% had poor outcome and 14% had SIRPIDs. There was no significant difference in outcome between patients with and without SIRPIDs, even when subgrouped according to underlying main EEG-pattern. Comparing subtypes of SIRPIDs, 82% of patients with stimulus-induced periodic discharges had poor outcome compared to 44% of patients with stimulus-induced rhythmic delta activity, but the difference was not significant. Conclusions: In EEGs performed ≥36 h after cardiac arrest, SIRPIDs cannot be used to reliably predict poor outcome. Whether certain subtypes of SIRPIDs indicate worse prognosis needs further investigation. Significance: Categorising the main EEG-pattern has important prognostic implications, but assessment of late appearing SIRPIDs does not seem to add prognostic information.</p>}},
author = {{Broman, N. Jaffer and Backman, S. and Westhall, E.}},
issn = {{2467-981X}},
keywords = {{Cardiac arrest; Coma; EEG; Prognosis; SIRPIDs}},
language = {{eng}},
pages = {{219--224}},
publisher = {{Elsevier}},
series = {{Clinical Neurophysiology Practice}},
title = {{Stimulus-induced EEG-patterns and outcome after cardiac arrest}},
url = {{http://dx.doi.org/10.1016/j.cnp.2021.07.001}},
doi = {{10.1016/j.cnp.2021.07.001}},
volume = {{6}},
year = {{2021}},
}