title: Electroencephalography reactivity for prognostication of post-anoxic coma after cardiopulmonary resuscitation: A comparison of quantitative analysis and visual analysis.
abstract: Electroencephalogram reactivity (EEG-R) is a positive predictive factor for assessing outcomes in comatose patients. Most studies assess the prognostic value of EEG-R utilizing visual analysis; however, this method is prone to subjectivity. We sought to categorize EEG-R with a quantitative approach. We retrospectively studied consecutive comatose patients who had an EEG-R recording performed 1-3 days after cardiopulmonary resuscitation (CPR) or during normothermia after therapeutic hypothermia. EEG-R was assessed via visual analysis and quantitative analysis separately. Clinical outcomes were followed-up at 3-month and dichotomized as recovery of awareness or no recovery of awareness. A total of 96 patients met the inclusion criteria, and 38 (40%) patients recovered awareness at 3-month followed-up. Of 27 patients with EEG-R measured with visual analysis, 22 patients recovered awareness; and of the 69 patients who did not demonstrated EEG-R, 16 patients recovered awareness. The sensitivity and specificity of visually measured EEG-R were 58% and 91%, respectively. The area under the receiver operating characteristic curve for the quantitative analysis was 0.92 (95% confidence interval, 0.87-0.97), with the best cut-off value of 0.10. EEG-R through quantitative analysis might be a good method in predicting the recovery of awareness in patients with post-anoxic coma after CPR.
authors.affiliation: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Liu
authors.affiliation: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China. Electronic address: suyingyingxwh@sina.com.
authors.forename: Yingying
authors.initials: Y
authors.lastname: Su
authors.affiliation: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Mengdi
authors.initials: M
authors.lastname: Jiang
authors.affiliation: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Weibi
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Yunzhou
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Daiquan
authors.initials: D
authors.lastname: Gao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001364:Awareness; D016887:Cardiopulmonary Resuscitation; D002540:Cerebral Cortex / Q000503:physiopathology*; D003128:Coma / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D000860:Hypoxia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012815:Signal Processing, Computer-Assisted; D055815:Young Adult
keywords: Cardiopulmonary resuscitation; Coma; EEG reactivity; Prognosis; Quantitative EEG