Outcome prediction by amplitude-integrated EEG in adults with hypoxic ischemic encephalopathy.
BACKGROUND
Amplitude-integrated electroencephalography (aEEG) had been widely used in predicting outcome in infants with hypoxic ischemic encephalopathy (HIE). We aimed to evaluate the use of aEEG as a quantitative predictor of outcome in adult patients with HIE.


METHODS
aEEG and Glasgow coma scale (GCS) were recorded for patients with HIE within 72 h of onset. aEEG traces were categorized as Grade I (normal amplitude): upper margin of aEEG activity >10 μV, lower margin >5 μV; Grade II (moderately abnormal amplitude): upper margin of aEEG activity >10 μV, lower margin ≤5 μV, or with suppressed amplitude, upper margin ≤10 μV, lower margin >5μV; Grade III (mild abnormality): either upper margin <10 μV, lower margin <5 μV. GCS was graded as I (9-14), grade II (4-8), or grade III (3). Cerebral performance category scores (CPCs) were determined 1 and 3 month after clinical evolution. CPC 1,2 were defined as favorable outcome; CPC 3,4,5 were considered as poor outcome.


RESULTS
30 cases met inclusion criteria. Both the aEEG grade and GCS scores correlated significantly with short-term outcome, and cases with a worse aEEG grade were more likely to have an unfavorable short-term outcome. Since the number of patients is really too small for long-term outcome analysis, we did not perform the analysis of aEEG, GCS and longer-term outcome. There was significant difference of clinical findings among aEEG classifications, while no statistical difference was found of causes of HIE.


CONCLUSIONS
aEEG is a reliable predictor of short-term outcome in HIE, and aEEG results within 72h after onset were associated with neurodevelopmental outcome at 1 mo following clinical evolution.
Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Ge
G
Tian
Kun
K
Qin
Yong-ming
YM
Wu
Zhong
Z
Ji
Jing-xin
JX
Wang
Su-yue
SY
Pan
D000328:Adult; D000704:Analysis of Variance; D016887:Cardiopulmonary Resuscitation; D003422:Critical Care; D004569:Electroencephalography / Q000379:methods*; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis* / Q000628:therapy*; D008875:Middle Aged; D009460:Neurologic Examination; D019095:Point-of-Care Systems; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome