Time to epileptiform activity and EEG background recovery are independent predictors after cardiac arrest
(2018) In Clinical Neurophysiology 129(8). p.1660-1668- Abstract
Objective: Investigate the temporal development of EEG and prognosis. Methods: Prospective observational substudy of the Target Temperature Management trial. Six sites performed simplified continuous EEG-monitoring (cEEG) on comatose patients after cardiac arrest, blinded to treating physicians. We determined time-points of recovery of a normal-voltage continuous background activity and the appearance of an epileptiform EEG, defined as abundant epileptiform discharges, periodic/rhythmic discharges or electrographic seizure activity. Results: 134 patients were included, 65 had a good outcome. Early recovery of continuous background activity (within 24 h) occurred in 72 patients and predicted good outcome since 55 (76%) had good outcome,... (More)
Objective: Investigate the temporal development of EEG and prognosis. Methods: Prospective observational substudy of the Target Temperature Management trial. Six sites performed simplified continuous EEG-monitoring (cEEG) on comatose patients after cardiac arrest, blinded to treating physicians. We determined time-points of recovery of a normal-voltage continuous background activity and the appearance of an epileptiform EEG, defined as abundant epileptiform discharges, periodic/rhythmic discharges or electrographic seizure activity. Results: 134 patients were included, 65 had a good outcome. Early recovery of continuous background activity (within 24 h) occurred in 72 patients and predicted good outcome since 55 (76%) had good outcome, increasing the odds for a good outcome seven times compared to a late background recovery. Early appearance of an epileptiform EEG occurred in 38 patients and 34 (89%) had a poor outcome, increasing the odds for a poor outcome six times compared to a late debut. The time to background recovery and the time to epileptiform activity were highly associated with outcome and levels of neuron-specific enolase. Multiple regression analysis showed that both variables were independent predictors. Conclusions: Time to epileptiform activity and background recovery are independent prognostic indicators. Significance: Patients with early background recovery combined with late appearance of epileptiform activity may have a good outcome.
(Less)
- author
- organization
- publishing date
- 2018-08-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cardiac arrest, Coma, Continuous EEG monitoring, EEG, Prognosis, Status epilepticus
- in
- Clinical Neurophysiology
- volume
- 129
- issue
- 8
- pages
- 9 pages
- publisher
- Elsevier
- external identifiers
-
- scopus:85048734370
- pmid:29933239
- ISSN
- 1388-2457
- DOI
- 10.1016/j.clinph.2018.05.016
- language
- English
- LU publication?
- yes
- id
- d8633dff-359c-4f2d-a9e7-88fc05a543eb
- date added to LUP
- 2018-06-27 16:15:23
- date last changed
- 2024-09-17 22:53:19
@article{d8633dff-359c-4f2d-a9e7-88fc05a543eb, abstract = {{<p>Objective: Investigate the temporal development of EEG and prognosis. Methods: Prospective observational substudy of the Target Temperature Management trial. Six sites performed simplified continuous EEG-monitoring (cEEG) on comatose patients after cardiac arrest, blinded to treating physicians. We determined time-points of recovery of a normal-voltage continuous background activity and the appearance of an epileptiform EEG, defined as abundant epileptiform discharges, periodic/rhythmic discharges or electrographic seizure activity. Results: 134 patients were included, 65 had a good outcome. Early recovery of continuous background activity (within 24 h) occurred in 72 patients and predicted good outcome since 55 (76%) had good outcome, increasing the odds for a good outcome seven times compared to a late background recovery. Early appearance of an epileptiform EEG occurred in 38 patients and 34 (89%) had a poor outcome, increasing the odds for a poor outcome six times compared to a late debut. The time to background recovery and the time to epileptiform activity were highly associated with outcome and levels of neuron-specific enolase. Multiple regression analysis showed that both variables were independent predictors. Conclusions: Time to epileptiform activity and background recovery are independent prognostic indicators. Significance: Patients with early background recovery combined with late appearance of epileptiform activity may have a good outcome.</p>}}, author = {{Westhall, E. and Rosén, I. and Rundgren, M. and Bro-Jeppesen, J. and Kjaergaard, J. and Hassager, C. and Lindehammar, H. and Horn, J. and Ullén, S. and Nielsen, N. and Friberg, H. and Cronberg, T.}}, issn = {{1388-2457}}, keywords = {{Cardiac arrest; Coma; Continuous EEG monitoring; EEG; Prognosis; Status epilepticus}}, language = {{eng}}, month = {{08}}, number = {{8}}, pages = {{1660--1668}}, publisher = {{Elsevier}}, series = {{Clinical Neurophysiology}}, title = {{Time to epileptiform activity and EEG background recovery are independent predictors after cardiac arrest}}, url = {{http://dx.doi.org/10.1016/j.clinph.2018.05.016}}, doi = {{10.1016/j.clinph.2018.05.016}}, volume = {{129}}, year = {{2018}}, }