title: Predictive value of an early amplitude integrated electroencephalogram and neurologic examination.
abstract: OBJECTIVE
  To examine the predictive validity of the amplitude integrated electroencephalogram (aEEG) and stage of encephalopathy among infants with hypoxic-ischemic encephalopathy (HIE) eligible for therapeutic whole-body hypothermia.
  
  
  METHODS
  Neonates were eligible for this prospective study if moderate or severe HIE occurred at <6 hours and an aEEG was obtained at <9 hours of age. The primary outcome was death or moderate/severe disability at 18 months.
  
  
  RESULTS
  There were 108 infants (71 with moderate HIE and 37 with severe HIE) enrolled in the study. aEEG findings were categorized as normal, with continuous normal voltage (n=12) or discontinuous normal voltage (n=12), or abnormal, with burst suppression (n=22), continuous low voltage (n=26), or flat tracing (n=36). At 18 months, 53 infants (49%) experienced death or disability. Severe HIE and an abnormal aEEG were related to the primary outcome with univariate analysis, whereas severe HIE alone was predictive of outcome with multivariate analysis. Addition of aEEG pattern to HIE stage did not add to the predictive value of the model; the area under the curve changed from 0.72 to 0.75 (P=.19).
  
  
  CONCLUSIONS
  The aEEG background pattern did not significantly enhance the value of the stage of encephalopathy at study entry in predicting death and disability among infants with HIE.
authors.affiliation: Department of Pediatrics, Wayne State University, Detroit, Michigan, USA. sshankar@med.wayne.edu
authors.forename: Seetha
authors.initials: S
authors.lastname: Shankaran
authors.forename: Athina
authors.initials: A
authors.lastname: Pappas
authors.forename: Scott A
authors.initials: SA
authors.lastname: McDonald
authors.forename: Abbot R
authors.initials: AR
authors.lastname: Laptook
authors.forename: Rebecca
authors.initials: R
authors.lastname: Bara
authors.forename: Richard A
authors.initials: RA
authors.lastname: Ehrenkranz
authors.forename: Jon E
authors.initials: JE
authors.lastname: Tyson
authors.forename: Ronald
authors.initials: R
authors.lastname: Goldberg
authors.forename: Edward F
authors.initials: EF
authors.lastname: Donovan
authors.forename: Avroy A
authors.initials: AA
authors.lastname: Fanaroff
authors.forename: Abhik
authors.initials: A
authors.lastname: Das
authors.forename: W Kenneth
authors.initials: WK
authors.lastname: Poole
authors.forename: Michele
authors.initials: M
authors.lastname: Walsh
authors.forename: Rosemary D
authors.initials: RD
authors.lastname: Higgins
authors.forename: Cherie
authors.initials: C
authors.lastname: Welsh
authors.forename: Walid
authors.initials: W
authors.lastname: Salhab
authors.forename: Waldemar A
authors.initials: WA
authors.lastname: Carlo
authors.forename: Brenda
authors.initials: B
authors.lastname: Poindexter
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Stoll
authors.forename: Ronnie
authors.initials: R
authors.lastname: Guillet
authors.forename: Neil N
authors.initials: NN
authors.lastname: Finer
authors.forename: David K
authors.initials: DK
authors.lastname: Stevenson
authors.forename: Charles R
authors.initials: CR
authors.lastname: Bauer
mesh_terms: D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis*; D007231:Infant, Newborn; D008297:Male; D009460:Neurologic Examination; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index