title: Predicting Outcome in Comatose Patients: The Role of EEG Reactivity to Quantifiable Electrical Stimuli.
abstract: Objective. To test the value of quantifiable electrical stimuli as a reliable method to assess electroencephalogram reactivity (EEG-R) for the early prognostication of outcome in comatose patients. Methods. EEG was recorded in consecutive adults in coma after cardiopulmonary resuscitation (CPR) or stroke. EEG-R to standard electrical stimuli was tested. Each patient received a 3-month follow-up by the Glasgow-Pittsburgh cerebral performance categories (CPC) or modified Rankin scale (mRS) score. Results. Twenty-two patients met the inclusion criteria. In the CPR group, 6 of 7 patients with EEG-R had good outcomes (positive predictive value (PPV), 85.7%) and 4 of 5 patients without EEG-R had poor outcomes (negative predictive value (NPV), 80%). The sensitivity and specificity were 85.7% and 80%, respectively. In the stroke group, 6 of 7 patients with EEG-R had good outcomes (PPV, 85.7%); all of the 3 patients without EEG-R had poor outcomes (NPV, 100%). The sensitivity and specificity were 100% and 75%, respectively. Of all patients, the presence of EEG-R showed 92.3% sensitivity, 77.7% specificity, 85.7% PPV, and 87.5% NPV. Conclusion. EEG-R to quantifiable electrical stimuli might be a good positive predictive factor for the prognosis of outcome in comatose patients after CPR or stroke.
authors.affiliation: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Liu
authors.affiliation: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
authors.forename: Yingying
authors.initials: Y
authors.lastname: Su
authors.affiliation: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
authors.forename: Yifei
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
authors.forename: Mengdi
authors.initials: M
authors.lastname: Jiang
authors.affiliation: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
authors.forename: Yunzhou
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
authors.forename: Daiquan
authors.initials: D
authors.lastname: Gao