Titre
EEG for good outcome prediction after cardiac arrest: A multicentre cohort study.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Turella, S.
Auteure/Auteur
Dankiewicz, J.
Auteure/Auteur
Ben-Hamouda, N.
Auteure/Auteur
Nilsen, K.B.
Auteure/Auteur
Düring, J.
Auteure/Auteur
Endisch, C.
Auteure/Auteur
Engstrøm, M.
Auteure/Auteur
Flügel, D.
Auteure/Auteur
Gaspard, N.
Auteure/Auteur
Grejs, A.M.
Auteure/Auteur
Haenggi, M.
Auteure/Auteur
Haffey, S.
Auteure/Auteur
Imbach, L.
Auteure/Auteur
Johnsen, B.
Auteure/Auteur
Kemlink, D.
Auteure/Auteur
Leithner, C.
Auteure/Auteur
Legriel, S.
Auteure/Auteur
Lindehammar, H.
Auteure/Auteur
Mazzon, G.
Auteure/Auteur
Nielsen, N.
Auteure/Auteur
Peyre, A.
Auteure/Auteur
Ribalta Stanford, B.
Auteure/Auteur
Roman-Pognuz, E.
Auteure/Auteur
Rossetti, A.O.
Auteure/Auteur
Schrag, C.
Auteure/Auteur
Valeriánová, A.
Auteure/Auteur
Wendel-Garcia, P.
Auteure/Auteur
Zubler, F.
Auteure/Auteur
Cronberg, T.
Auteure/Auteur
Westhall, E.
Auteure/Auteur
Groupes de travail
TTM2-trial investigators
Liens vers les personnes
Liens vers les unités
ISSN
1873-1570
Statut éditorial
Publié
Date de publication
2024-09
Volume
202
Première page
110319
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study ; Observational Study
Publication Status: ppublish
Publication Status: ppublish
Résumé
Assess the prognostic ability of a non-highly malignant and reactive EEG to predict good outcome after cardiac arrest (CA).
Prospective observational multicentre substudy of the "Targeted Hypothermia versus Targeted Normothermia after Out-of-hospital Cardiac Arrest Trial", also known as the TTM2-trial. Presence or absence of highly malignant EEG patterns and EEG reactivity to external stimuli were prospectively assessed and reported by the trial sites. Highly malignant patterns were defined as burst-suppression or suppression with or without superimposed periodic discharges. Multimodal prognostication was performed 96 h after CA. Good outcome at 6 months was defined as a modified Rankin Scale score of 0-3.
873 comatose patients at 59 sites had an EEG assessment during the hospital stay. Of these, 283 (32%) had good outcome. EEG was recorded at a median of 69 h (IQR 47-91) after CA. Absence of highly malignant EEG patterns was seen in 543 patients of whom 255 (29% of the cohort) had preserved EEG reactivity. A non-highly malignant and reactive EEG had 56% (CI 50-61) sensitivity and 83% (CI 80-86) specificity to predict good outcome. Presence of EEG reactivity contributed (p < 0.001) to the specificity of EEG to predict good outcome compared to only assessing background pattern without taking reactivity into account.
Nearly one-third of comatose patients resuscitated after CA had a non-highly malignant and reactive EEG that was associated with a good long-term outcome. Reactivity testing should be routinely performed since preserved EEG reactivity contributed to prognostic performance.
Prospective observational multicentre substudy of the "Targeted Hypothermia versus Targeted Normothermia after Out-of-hospital Cardiac Arrest Trial", also known as the TTM2-trial. Presence or absence of highly malignant EEG patterns and EEG reactivity to external stimuli were prospectively assessed and reported by the trial sites. Highly malignant patterns were defined as burst-suppression or suppression with or without superimposed periodic discharges. Multimodal prognostication was performed 96 h after CA. Good outcome at 6 months was defined as a modified Rankin Scale score of 0-3.
873 comatose patients at 59 sites had an EEG assessment during the hospital stay. Of these, 283 (32%) had good outcome. EEG was recorded at a median of 69 h (IQR 47-91) after CA. Absence of highly malignant EEG patterns was seen in 543 patients of whom 255 (29% of the cohort) had preserved EEG reactivity. A non-highly malignant and reactive EEG had 56% (CI 50-61) sensitivity and 83% (CI 80-86) specificity to predict good outcome. Presence of EEG reactivity contributed (p < 0.001) to the specificity of EEG to predict good outcome compared to only assessing background pattern without taking reactivity into account.
Nearly one-third of comatose patients resuscitated after CA had a non-highly malignant and reactive EEG that was associated with a good long-term outcome. Reactivity testing should be routinely performed since preserved EEG reactivity contributed to prognostic performance.
PID Serval
serval:BIB_A6AC31980138
PMID
Open Access
Oui
Date de création
2024-07-18T06:49:28.196Z
Date de création dans IRIS
2025-05-20T22:08:35Z