Bispectral index predicts deaths within 2 weeks in coma patients, a better predictor than serum neuron-specific enolase or S100 protein.
OBJECTIVE
We assessed the ability of bispectral index (BIS) to predict clinical outcome (dead or alive within 2 weeks).


METHODS
In total, 90 coma patients with severe brain injuries underwent BIS monitoring, and serum neuron-specific enolase (NSE) and S100 protein levels were assayed within the first 3 days of admission. Receiver operator characteristic (ROC) curve analysis was used to assess the performance of BIS values for predicting death within 2 weeks. A cutoff value was calculated using the Youden index.


RESULTS
A significant negative correlation was found between BIS value and serum NSE and S100 levels. The area under the curve for BIS value was 0.841 (p < 0.001, 95 % CI = 0.751-0.931), and higher than for NSE (0.713) (p = 0.002, 95 % CI = 0.582-0.844) or S100 (0.790) (p < 0.001, 95 % CI = 0.680-0.899). The optimal cutoff of BIS was 32.5. Serum NSE and S100 protein levels and the mortality rate were significantly lower in patients with a BIS value >32.5 than in patients with a BIS value ≤32.5.


CONCLUSIONS
Bispectral index values may reflect degree of brain injury, and BIS is an objective and noninvasive monitoring method for helping clinicians to predict death in patients with a BIS value ≤32.5.
Intensive Care Unit, Hospital No. 401 of the Chinese People's Liberation Army, Minjiang Road 22, Qingdao, 266071, Shandong, China, wenlimiao1212@hotmail.com.
Wenli
W
Miao
Yuanxin
Y
Zhang
Hailing
H
Li
D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000097:blood / Q000201:enzymology / Q000401:mortality; D003128:Coma / Q000097:blood* / Q000201:enzymology / Q000401:mortality*; D006801:Humans; D008875:Middle Aged; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D011446:Prospective Studies; D009418:S100 Proteins / Q000097:blood*
D009418:S100 Proteins; D010751:Phosphopyruvate Hydratase