Background frequency can enhance the prognostication power of EEG patterns categories in comatose cardiac arrest survivors: a prospective, multicenter, observational cohort study

Abstract Background We assessed the prognostic accuracy of the standardized electroencephalography (EEG) patterns (“highly malignant,” “malignant,” and “benign”) according to the EEG timing (early vs. late) and investigated the EEG features to enhance the predictive power for poor neurologic outcome...

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Autores principales:	Youn-Jung Kim, Min-Jee Kim, Yong Hwan Kim, Chun Song Youn, In Soo Cho, Su Jin Kim, Jung Hee Wee, Yoo Seok Park, Joo Suk Oh, Dong Hoon Lee, Won Young Kim, the Korean Hypothermia Network Investigators
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Out-of-hospital cardiac arrest Electroencephalography Prognosis Neurologic outcome Targeted temperature management Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/afae384b69b9478f949c82f3bd5336df
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spelling	oai:doaj.org-article:afae384b69b9478f949c82f3bd5336df2021-11-21T12:02:54ZBackground frequency can enhance the prognostication power of EEG patterns categories in comatose cardiac arrest survivors: a prospective, multicenter, observational cohort study10.1186/s13054-021-03823-y1364-8535https://doaj.org/article/afae384b69b9478f949c82f3bd5336df2021-11-01T00:00:00Zhttps://doi.org/10.1186/s13054-021-03823-yhttps://doaj.org/toc/1364-8535Abstract Background We assessed the prognostic accuracy of the standardized electroencephalography (EEG) patterns (“highly malignant,” “malignant,” and “benign”) according to the EEG timing (early vs. late) and investigated the EEG features to enhance the predictive power for poor neurologic outcome at 1 month after cardiac arrest. Methods This prospective, multicenter, observational, cohort study using data from Korean Hypothermia Network prospective registry included adult patients with out-of-hospital cardiac arrest (OHCA) treated with targeted temperature management (TTM) and underwent standard EEG within 7 days after cardiac arrest from 14 university-affiliated teaching hospitals in South Korea between October 2015 and December 2018. Early EEG was defined as EEG performed within 72 h after cardiac arrest. The primary outcome was poor neurological outcome (Cerebral Performance Category score 3–5) at 1 month. Results Among 489 comatose OHCA survivors with a median EEG time of 46.6 h, the “highly malignant” pattern (40.7%) was most prevalent, followed by the “benign” (33.9%) and “malignant” (25.4%) patterns. All patients with the highly malignant EEG pattern had poor neurologic outcomes, with 100% specificity in both groups but 59.3% and 56.1% sensitivity in the early and late EEG groups, respectively. However, for patients with “malignant” patterns, 84.8% sensitivity, 77.0% specificity, and 89.5% positive predictive value for poor neurologic outcome were observed. Only 3.5% (9/256) of patients with background EEG frequency of predominant delta waves or undetermined had good neurologic survival. The combination of “highly malignant” or “malignant” EEG pattern with background frequency of delta waves or undetermined increased specificity and positive predictive value, respectively, to up to 98.0% and 98.7%. Conclusions The “highly malignant” patterns predicted poor neurologic outcome with a high specificity regardless of EEG measurement time. The assessment of predominant background frequency in addition to EEG patterns can increase the prognostic value of OHCA survivors. Trial registration KORHN-PRO, NCT02827422 . Registered 11 September 2016—Retrospectively registered.Youn-Jung KimMin-Jee KimYong Hwan KimChun Song YounIn Soo ChoSu Jin KimJung Hee WeeYoo Seok ParkJoo Suk OhDong Hoon LeeWon Young Kimthe Korean Hypothermia Network InvestigatorsBMCarticleOut-of-hospital cardiac arrestElectroencephalographyPrognosisNeurologic outcomeTargeted temperature managementMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENCritical Care, Vol 25, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Out-of-hospital cardiac arrest Electroencephalography Prognosis Neurologic outcome Targeted temperature management Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Out-of-hospital cardiac arrest Electroencephalography Prognosis Neurologic outcome Targeted temperature management Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Youn-Jung Kim Min-Jee Kim Yong Hwan Kim Chun Song Youn In Soo Cho Su Jin Kim Jung Hee Wee Yoo Seok Park Joo Suk Oh Dong Hoon Lee Won Young Kim the Korean Hypothermia Network Investigators Background frequency can enhance the prognostication power of EEG patterns categories in comatose cardiac arrest survivors: a prospective, multicenter, observational cohort study
description	Abstract Background We assessed the prognostic accuracy of the standardized electroencephalography (EEG) patterns (“highly malignant,” “malignant,” and “benign”) according to the EEG timing (early vs. late) and investigated the EEG features to enhance the predictive power for poor neurologic outcome at 1 month after cardiac arrest. Methods This prospective, multicenter, observational, cohort study using data from Korean Hypothermia Network prospective registry included adult patients with out-of-hospital cardiac arrest (OHCA) treated with targeted temperature management (TTM) and underwent standard EEG within 7 days after cardiac arrest from 14 university-affiliated teaching hospitals in South Korea between October 2015 and December 2018. Early EEG was defined as EEG performed within 72 h after cardiac arrest. The primary outcome was poor neurological outcome (Cerebral Performance Category score 3–5) at 1 month. Results Among 489 comatose OHCA survivors with a median EEG time of 46.6 h, the “highly malignant” pattern (40.7%) was most prevalent, followed by the “benign” (33.9%) and “malignant” (25.4%) patterns. All patients with the highly malignant EEG pattern had poor neurologic outcomes, with 100% specificity in both groups but 59.3% and 56.1% sensitivity in the early and late EEG groups, respectively. However, for patients with “malignant” patterns, 84.8% sensitivity, 77.0% specificity, and 89.5% positive predictive value for poor neurologic outcome were observed. Only 3.5% (9/256) of patients with background EEG frequency of predominant delta waves or undetermined had good neurologic survival. The combination of “highly malignant” or “malignant” EEG pattern with background frequency of delta waves or undetermined increased specificity and positive predictive value, respectively, to up to 98.0% and 98.7%. Conclusions The “highly malignant” patterns predicted poor neurologic outcome with a high specificity regardless of EEG measurement time. The assessment of predominant background frequency in addition to EEG patterns can increase the prognostic value of OHCA survivors. Trial registration KORHN-PRO, NCT02827422 . Registered 11 September 2016—Retrospectively registered.
format	article
author	Youn-Jung Kim Min-Jee Kim Yong Hwan Kim Chun Song Youn In Soo Cho Su Jin Kim Jung Hee Wee Yoo Seok Park Joo Suk Oh Dong Hoon Lee Won Young Kim the Korean Hypothermia Network Investigators
author_facet	Youn-Jung Kim Min-Jee Kim Yong Hwan Kim Chun Song Youn In Soo Cho Su Jin Kim Jung Hee Wee Yoo Seok Park Joo Suk Oh Dong Hoon Lee Won Young Kim the Korean Hypothermia Network Investigators
author_sort	Youn-Jung Kim
title	Background frequency can enhance the prognostication power of EEG patterns categories in comatose cardiac arrest survivors: a prospective, multicenter, observational cohort study
title_short	Background frequency can enhance the prognostication power of EEG patterns categories in comatose cardiac arrest survivors: a prospective, multicenter, observational cohort study
title_full	Background frequency can enhance the prognostication power of EEG patterns categories in comatose cardiac arrest survivors: a prospective, multicenter, observational cohort study
title_fullStr	Background frequency can enhance the prognostication power of EEG patterns categories in comatose cardiac arrest survivors: a prospective, multicenter, observational cohort study
title_full_unstemmed	Background frequency can enhance the prognostication power of EEG patterns categories in comatose cardiac arrest survivors: a prospective, multicenter, observational cohort study
title_sort	background frequency can enhance the prognostication power of eeg patterns categories in comatose cardiac arrest survivors: a prospective, multicenter, observational cohort study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/afae384b69b9478f949c82f3bd5336df
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Background frequency can enhance the prognostication power of EEG patterns categories in comatose cardiac arrest survivors: a prospective, multicenter, observational cohort study

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