Outcome prediction by amplitude-integrated EEG in adults with hypoxic ischemic encephalopathy

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• 作者：Ge Tian^a ; ¹ ; Kun Qin^b ; ¹ ; Yong-ming Wu^a ; Zhong Ji^a ; Jing-xin Wang^a ; Su-yue Pan^a ; ^{pansuyue@126.com}
• 关键词：aEEG ; amplitude-integrated electroencephalography ; CPCs ; cerebral performance category scores ; EEG ; electroencephalography ; GCS ; Glasgow coma scale ; HIE ; hypoxic ischemic encephalopathy ; NICU ; neurological intensive care unit
• 刊名：Clinical Neurology and Neurosurgery
• 出版年：2012
• 期刊代码：60_03038467
• 类别：med
• 出版时间：July, 2012
• 卷：114
• 期：6
• 页码：585-589
• 文件大小：185 K

摘要

Introduction

Amplitude-integrated electroencephalography (aEEG) had been widely used in predicting outcome in infants with hypoxic ischemic encephalopathy (HIE). We aimed to evaluate the use of aEEG as a quantitative predictor of outcome in adult patients with HIE.

Methods

aEEG and Glasgow coma scale (GCS) were recorded for patients with HIE within 72 h of onset. aEEG traces were categorized as Grade I (normal amplitude): upper margin of aEEG activity >10 渭V, lower margin >5 渭V; Grade II (moderately abnormal amplitude): upper margin of aEEG activity >10 渭V, lower margin 鈮? 渭V, or with suppressed amplitude, upper margin 鈮?0 渭V, lower margin >5 渭V; Grade III (mild abnormality): either upper margin <10 渭V, lower margin <5 渭V. GCS was graded as I (9-14), grade II (4-8), or grade III (3). Cerebral performance category scores (CPCs) were determined 1 and 3 month after clinical evolution. CPC 1,2 were defined as favorable outcome; CPC 3,4,5 were considered as poor outcome.

Results

30 cases met inclusion criteria. Both the aEEG grade and GCS scores correlated significantly with short-term outcome, and cases with a worse aEEG grade were more likely to have an unfavorable short-term outcome. Since the number of patients is really too small for long-term outcome analysis, we did not perform the analysis of aEEG, GCS and longer-term outcome. There was significant difference of clinical findings among aEEG classifications, while no statistical difference was found of causes of HIE.

Conclusions

aEEG is a reliable predictor of short-term outcome in HIE, and aEEG results within 72 h after onset were associated with neurodevelopmental outcome at 1 mo following clinical evolution.