title: A Comparison of the Thompson Encephalopathy Score and Amplitude-Integrated Electroencephalography in Infants with Perinatal Asphyxia and Therapeutic Hypothermia.
abstract: BACKGROUND
  In previous studies clinical signs or amplitude-integrated electroencephalography (aEEG)-based signs of encephalopathy were used to select infants with perinatal asphyxia for treatment with hypothermia.
  
  
  OBJECTIVE
  The objective of this study was to compare Thompson encephalopathy scores and aEEG, and relate both to outcome.
  
  
  METHODS
  Thompson scores, aEEG, and outcome were compared in 122 infants with perinatal asphyxia and therapeutic hypothermia. Of these 122 infants, 41 died and 7 had an adverse neurodevelopmental outcome. A receiver operating characteristics (ROC) analysis was also performed.
  
  
  RESULTS
  Thompson scores were higher in infants with more abnormal aEEG background patterns (ANOVA, p < 0.001). The ROC analysis demonstrated that a Thompson score of 11 or higher or an aEEG background pattern of continuous low voltage or worse was associated with an adverse outcome (AUC 0.84 for both).
  
  
  CONCLUSIONS
  High Thompson scores and a suppressed aEEG background pattern are associated with an adverse outcome after perinatal asphyxia and therapeutic hypothermia. Further studies are needed to identify the best technique with which to select patients for therapeutic hypothermia.
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Lauren C
authors.initials: LC
authors.lastname: Weeke
authors.forename: Ana
authors.initials: A
authors.lastname: Vilan
authors.forename: Mona C
authors.initials: MC
authors.lastname: Toet
authors.forename: Ingrid C
authors.initials: IC
authors.lastname: van Haastert
authors.forename: Linda S
authors.initials: LS
authors.lastname: de Vries
authors.forename: Floris
authors.initials: F
authors.lastname: Groenendaal
mesh_terms: D000704:Analysis of Variance; D019540:Area Under Curve; D001238:Asphyxia Neonatorum / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D001921:Brain / Q000503:physiopathology*; D058256:Brain Waves; D002657:Child Development; D002675:Child, Preschool; D000066491:Clinical Decision-Making; D003661:Decision Support Techniques; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects / Q000401:mortality; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018579:Patient Selection; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012815:Signal Processing, Computer-Assisted; D013997:Time Factors; D016896:Treatment Outcome
keywords: Electroencephalography; Encephalopathy; Neurodevelopment; Perinatal asphyxia; Therapeutic hypothermia; Thompson score