title: Early single-channel aEEG/EEG predicts outcome in very preterm infants.
abstract: OBJECTIVE
  To characterize early amplitude-integrated electroencephalogram (aEEG) and single-channel EEG (aEEG/EEG) in very preterm (VPT) infants for prediction of long-term outcome.
  
  
  METHODS
  Forty-nine infants with median (range) gestational age of 25 (22-30) weeks.
  
  
  METHODS
  Amplitude-integrated electroencephalogram/EEG recorded during the first 72 h and analysed over 0-12, 12-24, 24-48 and 48-72 h, for background pattern, sleep-wake cycling, seizures, interburst intervals (IBI) and interburst percentage (IB%). In total, 2614 h of single-channel EEG examined for seizures. Survivors were assessed at 2 years corrected age with a neurological examination and Bayley Scales of Infant Development-II. Poor outcome was defined as death or survival with neurodevelopmental impairment. Good outcome was defined as survival without impairment.
  
  
  RESULTS
  Thirty infants had good outcome. Poor outcome (n = 19) was associated with depressed aEEG/EEG already during the first 12 h (p = 0.023), and with prolonged IBI and higher IB% at 24 h. Seizures were present in 43% of the infants and associated with intraventricular haemorrhages but not with outcome. Best predictors of poor outcome were burst-suppression pattern [76% correctly predicted; positive predictive value (PPV) 63%, negative predictive value (NPV) 91%], IBI > 6 sec (74% correctly predicted; PPV 67%, NPV 79%) and IB% > 55% at 24 h age (79% correctly predicted; PPV 72%, NPV 80%). In 35 infants with normal cerebral ultrasound during the first 3 days, outcome was correctly predicted in 82% by IB% (PPV 82%, NPV 83%).
  
  
  CONCLUSIONS
  Long-term outcome can be predicted by aEEG/EEG with 75-80% accuracy already at 24 postnatal hours in VPT infants, also in infants with no early indication of brain injury.
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Sweden. sverre.wikstrom@liv.se
authors.forename: Sverre
authors.initials: S
authors.lastname: Wikström
authors.forename: Ingrid Hansen
authors.initials: IH
authors.lastname: Pupp
authors.forename: Ingmar
authors.initials: I
authors.lastname: Rosén
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Norman
authors.forename: Vineta
authors.initials: V
authors.lastname: Fellman
authors.forename: David
authors.initials: D
authors.lastname: Ley
authors.forename: Lena
authors.initials: L
authors.lastname: Hellström-Westas
mesh_terms: D001766:Blindness / Q000175:diagnosis / Q000503:physiopathology; D001925:Brain Damage, Chronic / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D002547:Cerebral Palsy / Q000175:diagnosis / Q000503:physiopathology; D002675:Child, Preschool; D003638:Deafness / Q000175:diagnosis / Q000503:physiopathology; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D004569:Electroencephalography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012640:Seizures / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D012680:Sensitivity and Specificity; D015996:Survival Rate