Reduced EEG montage has a high accuracy in the post cardiac arrest setting
(2020) In Clinical Neurophysiology 131(9). p.2216-2223- Abstract
Objective: To study if comatose cardiac arrest patients can be assessed with a reduced number of EEG electrodes. Methods: 110 routine EEGs from 67 consecutive patients, including both hypothermic and normothermic EEGs were retrospectively assessed by three blinded EEG-experts using two different electrode montages. A standard 19-electrode-montage was compared to the reduced version of the same EEGs, down-sampled to six electrodes (F3, T3, P3, F4, T4, P4). We used intra-rater and inter-observer statistics to assess the reliability of the reduced montage for background features and discharges. Results: The reduced montage had almost perfect performance for background continuity (κ 0.80–0.88), including identification of highly malignant... (More)
Objective: To study if comatose cardiac arrest patients can be assessed with a reduced number of EEG electrodes. Methods: 110 routine EEGs from 67 consecutive patients, including both hypothermic and normothermic EEGs were retrospectively assessed by three blinded EEG-experts using two different electrode montages. A standard 19-electrode-montage was compared to the reduced version of the same EEGs, down-sampled to six electrodes (F3, T3, P3, F4, T4, P4). We used intra-rater and inter-observer statistics to assess the reliability of the reduced montage for background features and discharges. Results: The reduced montage had almost perfect performance for background continuity (κ 0.80–0.88), including identification of highly malignant backgrounds (burst-suppression/suppression) (κ 0.85–0.94) and benign backgrounds (continuous/nearly continuous) (κ 0.85–0.91). We found substantial performance for identifying rhythmic/periodic discharges (κ 0.79–0.86). The reduced montage had high accuracy for assessment of both highly malignant (sensitivity 91–95%, specificity 94–99%) and benign (sensitivity 89–98%, specificity 91–96%) backgrounds, and periodic/rhythmic patterns (sensitivity 79–100%, specificity 89–99%), compared to the full montage. The inter-observer variability was not increased by the reduced montage. Conclusion: Reduced EEG had high performance for classifying important background and discharge patterns in this post cardiac arrest cohort. Significance: Our results support the use of reduced EEG-montage for monitoring comatose cardiac arrest patients.
(Less)
- author
- Backman, Sofia LU ; Cronberg, Tobias LU ; Rosén, Ingmar LU and Westhall, Erik LU
- organization
- publishing date
- 2020-09
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cardiac arrest, Coma, EEG monitoring, Montage, Postanoxic encephalopathy
- in
- Clinical Neurophysiology
- volume
- 131
- issue
- 9
- pages
- 8 pages
- publisher
- Elsevier
- external identifiers
-
- pmid:32711346
- scopus:85088216025
- ISSN
- 1388-2457
- DOI
- 10.1016/j.clinph.2020.06.021
- language
- English
- LU publication?
- yes
- id
- f1247d59-7cc9-4514-8cd1-e188d7e40fa0
- date added to LUP
- 2021-01-12 15:23:10
- date last changed
- 2024-06-27 06:24:36
@article{f1247d59-7cc9-4514-8cd1-e188d7e40fa0,
abstract = {{<p>Objective: To study if comatose cardiac arrest patients can be assessed with a reduced number of EEG electrodes. Methods: 110 routine EEGs from 67 consecutive patients, including both hypothermic and normothermic EEGs were retrospectively assessed by three blinded EEG-experts using two different electrode montages. A standard 19-electrode-montage was compared to the reduced version of the same EEGs, down-sampled to six electrodes (F3, T3, P3, F4, T4, P4). We used intra-rater and inter-observer statistics to assess the reliability of the reduced montage for background features and discharges. Results: The reduced montage had almost perfect performance for background continuity (κ 0.80–0.88), including identification of highly malignant backgrounds (burst-suppression/suppression) (κ 0.85–0.94) and benign backgrounds (continuous/nearly continuous) (κ 0.85–0.91). We found substantial performance for identifying rhythmic/periodic discharges (κ 0.79–0.86). The reduced montage had high accuracy for assessment of both highly malignant (sensitivity 91–95%, specificity 94–99%) and benign (sensitivity 89–98%, specificity 91–96%) backgrounds, and periodic/rhythmic patterns (sensitivity 79–100%, specificity 89–99%), compared to the full montage. The inter-observer variability was not increased by the reduced montage. Conclusion: Reduced EEG had high performance for classifying important background and discharge patterns in this post cardiac arrest cohort. Significance: Our results support the use of reduced EEG-montage for monitoring comatose cardiac arrest patients.</p>}},
author = {{Backman, Sofia and Cronberg, Tobias and Rosén, Ingmar and Westhall, Erik}},
issn = {{1388-2457}},
keywords = {{Cardiac arrest; Coma; EEG monitoring; Montage; Postanoxic encephalopathy}},
language = {{eng}},
number = {{9}},
pages = {{2216--2223}},
publisher = {{Elsevier}},
series = {{Clinical Neurophysiology}},
title = {{Reduced EEG montage has a high accuracy in the post cardiac arrest setting}},
url = {{http://dx.doi.org/10.1016/j.clinph.2020.06.021}},
doi = {{10.1016/j.clinph.2020.06.021}},
volume = {{131}},
year = {{2020}},
}