title: Predicting Outcome in Postanoxic Coma: Are Ten EEG Electrodes Enough?
abstract: BACKGROUND
  Increasing evidence supports that early EEG recordings reliably contribute to outcome prediction in comatose patients with postanoxic encephalopathy. As postanoxic encephalopathy typically results in generalized EEG abnormalities, spatial resolution of a small number of electrodes is likely sufficient, which will reduce set-up time. Here, the authors compare a reduced and a 21-channel EEG for outcome prediction.
  
  
  METHODS
  EEG recordings from 142 prospectively collected patients with postanoxic encephalopathy were reassessed by two independent reviewers using a reduced (10 electrodes) bipolar montage. Classification and prognostic accuracy were compared with the full (21 electrodes) montage. The full montage consensus was considered Gold Standard.
  
  
  RESULTS
  Sixty-seven patients (47%) had good outcome. The agreement between the individual reviewers using the reduced montage and the Gold Standard score was good (κ = 0.75-0.79). The interobserver agreement was not affected by reducing the number of electrodes (κ = 0.78 for the reduced montage vs. 0.71 for the full montage). An isoelectric, low-voltage, or burst-suppression with identical bursts pattern at 24 hours invariably predicted poor outcome in both montages, with similar prognostic accuracy. A diffusely slowed or normal EEG pattern at 12 hours was associated with good outcome in both montages.
  
  
  CONCLUSIONS
  Reducing the number of electrodes from 21 to 10 does not affect EEG classification or prognostic accuracy in patients with postanoxic coma.
authors: *Departments of Clinical Neurophysiology and Neurology, Medisch Spectrum Twente, Enschede, the Netherlands; †Clinical Neurophysiology, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, the Netherlands; ‡Department of Neurology, Rijnstate Hospital, Arnhem, the Netherlands; §Department of Intensive Care, Medisch Spectrum Twente, Enschede, the Netherlands; and ‖Department of Intensive Care, Rijnstate Hospital, Arnhem, the Netherlands.
authors: Marleen C
authors: MC
authors: Tjepkema-Cloostermans
authors: Jeannette
authors: J
authors: Hofmeijer
authors: Harold W
authors: HW
authors: Hom
authors: Frank H
authors: FH
authors: Bosch
authors: Michel J A M
authors: MJAM
authors: van Putten
mesh_terms: D003128:Coma / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D004569:Electroencephalography / Q000295:instrumentation* / Q000379:methods / Q000592:standards*; D006801:Humans; D002534:Hypoxia, Brain / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D017063:Outcome Assessment, Health Care / Q000592:standards*; D011379:Prognosis