EEG patterns and their correlations with short- and long-term mortality in patients with hypoxic encephalopathy. Issue 11 (November 2021)

• Record Type: Journal Article
• Authors: Willems, Laurent M.; Trienekens, Franziska; Knake, Susanne; Beuchat, Isabelle; Rosenow, Felix; Schieffer, Bernhard; Karatolios, Konstantinos; Strzelczyk, Adam
• Is Part Of: Clinical neurophysiology. Volume 132:Issue 11(2021)
• Page Start: 2851
• Page End: 2860
• Publication Date: 2021-11
• Subjects: Intensive care -- Seizure -- Cardiac arrest -- Post-anoxic coma -- Prognostication; ACNS American Clinical Neurophysiology Society -- Ag silver, lat. argentum -- AgCl silver chloride -- ARDS acute respiratory distress symptom -- BA background activity -- aBA absence of background activity -- BI bilateral independent -- BSP burst-suppression pattern -- CA cardiac arrest -- CCI Charlson Comorbidity Index -- CI confidence interval -- CPR cardiopulmonary resuscitation -- DGKN Deutsche Gesellschaft für Klinische Neurophysiologie und Funktionelle Bildgebung -- ECG electrocardiogram -- EEG electroencephalogram -- EOG electrooculogram -- FC forecast -- G generalized -- GPD generalized periodic discharges -- GRDA generalized rhythmic delta activity -- HE hypoxic encephalopathy -- HIS hospital information system -- HR hazard ratio -- ICU intensive care unit -- L lateralized -- LAS Lance-Adams syndrome -- LPD lateralized periodic discharges -- LRDA lateralized rhythmic delta activity -- LV low-voltage EEG -- MCR multivariate cox regression analysis -- Mf multifocal -- mRS modified Rankin Scale -- MSE myoclonic status epilepticus -- n.a. not available -- nrBA non-reactive background activity -- PD periodic discharges -- PHM post-hypoxic myoclonus -- PSE post-hypoxic status epilepticus -- RDA rhythmic delta activity -- RECORD Reporting of studies Conducted using Observational Routinely-collected Data, ROSC, return of spontaneous circulation -- RPP rhythmic and periodic patterns -- SD standard deviation -- SE status epilepticus -- SIPRIDS stimulus-induced periodic, rhythmic or ictal discharges -- STROBE Strengthening the Reporting of Observational studies in Epidemiology -- SUDEP sudden unexpected death in epilepsy patients -- SUP EEG suppression -- SW sharp wave -- TTM therapeutic temperature management -- UKGM University Hospital Giessen and Marburg -- WLST withdrawal of life support -- +F fast -- +R rhythmic -- +S sharp -- +FR fast and rhythmic -- +FS fast and sharp; Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2021.07.026
• Languages: English
• ISSNs: 1388-2457

Abstract

Highlights: Early EEG is a reliable biomarker for overall, short- and long-term prognosis in patients with hypoxic encephalopathy. Prevalence of EEG suppression is associated with a poor short-term prognosis. Different EEG pattern are associated with an increased overall, short- and long-term mortality to various extents. Abstract: Objective: To analyze the association between electroencephalographic (EEG) patterns and overall, short- and long-term mortality in patients with hypoxic encephalopathy (HE). Methods: Retrospective, mono-center analysis of 199 patients using univariate log-rank tests (LR) and multivariate cox regression (MCR). Results: Short-term mortality, defined as death within 30-days post-discharge was 54.8%. Long-term mortality rates were 69.8%, 71.9%, and 72.9%, at 12-, 24-, and 36-months post-HE, respectively. LR revealed a significant association between EEG suppression (SUP) and short-term mortality, and identified low voltage EEG (LV), burst suppression (BSP), periodic discharges (PD) and post-hypoxic status epilepticus (PSE) as well as missing (aBA) or non-reactive background activity (nrBA) as predictors for overall, short- and long-term mortality. MCR indicated SUP, LV, BSP, PD, aBA and nrBA as significantly associated with overall and short-term mortality to varying extents. LV and BSP were significant predictors for long-term mortality in short-term survivors. Rhythmic delta activity, stimulus induced rhythmic, periodic or ictal discharges and sharp waves were not significantly associated with a higher mortality. Conclusion: The presence of several specific EEG patterns can help to predict overall, short- and long-term mortality in HE patients. Significance: The present findings may help to improve the challenging prognosis estimation in HE patients.