EEG recording latency in critically ill patients: Impact on outcome. An analysis of a randomized controlled trial (CERTA). (July 2022)

• Record Type: Journal Article
• Authors: Urbano, Valentina; Novy, Jan; Alvarez, Vincent; Schindler, Kaspar; Rüegg, Stephan; Rossetti, Andrea O.
• Is Part Of: Clinical neurophysiology. Volume 139(2022)
• Page Start: 23
• Page End: 27
• Publication Date: 2022-07
• Subjects: Electroencephalography -- Seizures -- Status epilepticus -- Intensive care unit -- Prognosis; ACNS American Clinical Neurophysiology Society -- cEEG continuous electroencephalogram -- CERTA Continuous EEG Randomized Trial in Adults -- CPC Cerebral Performance Category -- EEG electroencephalogram -- FOUR Full Outline Of Unresponsiveness -- GCS Glasgow Coma Scale -- GPDs generalized periodic discharges -- GRDA generalized rhythmic delta activity -- IQR interquartile range -- LPDs lateralized periodic discharges -- LRDA lateralized rhythmic delta activity -- mRS modified Rankin Score -- rEEG routine electroencephalogram -- SE status epilepticus; Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2022.04.003
• Languages: English
• ISSNs: 1388-2457

Abstract

Graphical abstract: Highlights: We explored if latency to EEG recordings in critically ill adults has an impact on outcome. No correlation was found between EEG delay and mortality or functional outcome. Continuous EEG increases seizure/status epilepticus detection but did not correlate with outcome. Abstract: Objective: To assess, in adults with acute consciousness impairment, the impact of latency between hospital admission and EEG recording start, and their outcome. Methods: We reviewed data of the CERTA trial (NCT03129438) and explored correlations between EEG recording latency and mortality, Cerebral Performance Categories (CPC), and modified Rankin Scale (mRS) at 6 months, considering other variables, using uni- and multivariable analyses. Results: In univariable analysis of 364 adults, median latency between admission and EEG recordings was comparable between surviving (61.1 h; IQR: 24.3–137.7) and deceased patients (57.5 h; IQR: 22.3–141.1); p = 0.727. This did not change after adjusting for potential confounders, such as lower Glasgow Coma Score on enrolment (p < 0.001) and seizure or status epilepticus detection (p < 0.001). There was neither any correlation between EEG latency and mRS (rho 0.087, p 0.236), nor with CPC (rho = 0.027, p = 0.603). Conclusion: This analysis shows no correlation between delays of EEG recordings and mortality or functional outcomes at 6 months in critically ill adults. Significance: These findings might suggest that in critically ill adults mortality correlates with underlying brain injury rather than EEG delay.