Standardized EEG interpretation accurately predicts prognosis after cardiac arrest

Research output: Contribution to journal › Journal article › Research › peer-review

Standard

Standardized EEG interpretation accurately predicts prognosis after cardiac arrest. / Westhall, Erik; Rossetti, Andrea O; van Rootselaar, Anne-Fleur; Wesenberg Kjaer, Troels; Horn, Janneke; Ullén, Susann; Friberg, Hans; Nielsen, Niklas; Rosén, Ingmar; Åneman, Anders; Erlinge, David; Gasche, Yvan; Hassager, Christian; Hovdenes, Jan; Kjaergaard, Jesper; Kuiper, Michael; Pellis, Tommaso; Stammet, Pascal; Wanscher, Michael; Wetterslev, Jørn; Wise, Matt P; Cronberg, Tobias.

In: Neurology, Vol. 86, No. 16, 19.04.2016, p. 1482-1490.

Research output: Contribution to journal › Journal article › Research › peer-review

Harvard

Westhall, E, Rossetti, AO, van Rootselaar, A-F, Wesenberg Kjaer, T, Horn, J, Ullén, S, Friberg, H, Nielsen, N, Rosén, I, Åneman, A, Erlinge, D, Gasche, Y, Hassager, C, Hovdenes, J, Kjaergaard, J, Kuiper, M, Pellis, T, Stammet, P, Wanscher, M, Wetterslev, J, Wise, MP & Cronberg, T 2016, 'Standardized EEG interpretation accurately predicts prognosis after cardiac arrest', Neurology, vol. 86, no. 16, pp. 1482-1490. https://doi.org/10.1212/WNL.0000000000002462

APA

Westhall, E., Rossetti, A. O., van Rootselaar, A-F., Wesenberg Kjaer, T., Horn, J., Ullén, S., Friberg, H., Nielsen, N., Rosén, I., Åneman, A., Erlinge, D., Gasche, Y., Hassager, C., Hovdenes, J., Kjaergaard, J., Kuiper, M., Pellis, T., Stammet, P., Wanscher, M., ... Cronberg, T. (2016). Standardized EEG interpretation accurately predicts prognosis after cardiac arrest. Neurology, 86(16), 1482-1490. https://doi.org/10.1212/WNL.0000000000002462

Vancouver

Westhall E, Rossetti AO, van Rootselaar A-F, Wesenberg Kjaer T, Horn J, Ullén S et al. Standardized EEG interpretation accurately predicts prognosis after cardiac arrest. Neurology. 2016 Apr 19;86(16):1482-1490. https://doi.org/10.1212/WNL.0000000000002462

Author

Westhall, Erik ; Rossetti, Andrea O ; van Rootselaar, Anne-Fleur ; Wesenberg Kjaer, Troels ; Horn, Janneke ; Ullén, Susann ; Friberg, Hans ; Nielsen, Niklas ; Rosén, Ingmar ; Åneman, Anders ; Erlinge, David ; Gasche, Yvan ; Hassager, Christian ; Hovdenes, Jan ; Kjaergaard, Jesper ; Kuiper, Michael ; Pellis, Tommaso ; Stammet, Pascal ; Wanscher, Michael ; Wetterslev, Jørn ; Wise, Matt P ; Cronberg, Tobias. / Standardized EEG interpretation accurately predicts prognosis after cardiac arrest. In: Neurology. 2016 ; Vol. 86, No. 16. pp. 1482-1490.

Bibtex

@article{6ad189c78c0c4b7692c469a5336c893f,
title = "Standardized EEG interpretation accurately predicts prognosis after cardiac arrest",
abstract = "OBJECTIVE: To identify reliable predictors of outcome in comatose patients after cardiac arrest using a single routine EEG and standardized interpretation according to the terminology proposed by the American Clinical Neurophysiology Society.METHODS: In this cohort study, 4 EEG specialists, blinded to outcome, evaluated prospectively recorded EEGs in the Target Temperature Management trial (TTM trial) that randomized patients to 33°C vs 36°C. Routine EEG was performed in patients still comatose after rewarming. EEGs were classified into highly malignant (suppression, suppression with periodic discharges, burst-suppression), malignant (periodic or rhythmic patterns, pathological or nonreactive background), and benign EEG (absence of malignant features). Poor outcome was defined as best Cerebral Performance Category score 3-5 until 180 days.RESULTS: Eight TTM sites randomized 202 patients. EEGs were recorded in 103 patients at a median 77 hours after cardiac arrest; 37% had a highly malignant EEG and all had a poor outcome (specificity 100%, sensitivity 50%). Any malignant EEG feature had a low specificity to predict poor prognosis (48%) but if 2 malignant EEG features were present specificity increased to 96% (p < 0.001). Specificity and sensitivity were not significantly affected by targeted temperature or sedation. A benign EEG was found in 1% of the patients with a poor outcome.CONCLUSIONS: Highly malignant EEG after rewarming reliably predicted poor outcome in half of patients without false predictions. An isolated finding of a single malignant feature did not predict poor outcome whereas a benign EEG was highly predictive of a good outcome.",
author = "Erik Westhall and Rossetti, {Andrea O} and {van Rootselaar}, Anne-Fleur and {Wesenberg Kjaer}, Troels and Janneke Horn and Susann Ull{\'e}n and Hans Friberg and Niklas Nielsen and Ingmar Ros{\'e}n and Anders {\AA}neman and David Erlinge and Yvan Gasche and Christian Hassager and Jan Hovdenes and Jesper Kjaergaard and Michael Kuiper and Tommaso Pellis and Pascal Stammet and Michael Wanscher and J{\o}rn Wetterslev and Wise, {Matt P} and Tobias Cronberg",
note = "{\textcopyright} 2016 American Academy of Neurology.",
year = "2016",
month = apr,
day = "19",
doi = "10.1212/WNL.0000000000002462",
language = "English",
volume = "86",
pages = "1482--1490",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams & Wilkins",
number = "16",

}

RIS

TY - JOUR

T1 - Standardized EEG interpretation accurately predicts prognosis after cardiac arrest

AU - Westhall, Erik

AU - Rossetti, Andrea O

AU - van Rootselaar, Anne-Fleur

AU - Wesenberg Kjaer, Troels

AU - Horn, Janneke

AU - Ullén, Susann

AU - Friberg, Hans

AU - Nielsen, Niklas

AU - Rosén, Ingmar

AU - Åneman, Anders

AU - Erlinge, David

AU - Gasche, Yvan

AU - Hassager, Christian

AU - Hovdenes, Jan

AU - Kjaergaard, Jesper

AU - Kuiper, Michael

AU - Pellis, Tommaso

AU - Stammet, Pascal

AU - Wanscher, Michael

AU - Wetterslev, Jørn

AU - Wise, Matt P

AU - Cronberg, Tobias

N1 - © 2016 American Academy of Neurology.

PY - 2016/4/19

Y1 - 2016/4/19

N2 - OBJECTIVE: To identify reliable predictors of outcome in comatose patients after cardiac arrest using a single routine EEG and standardized interpretation according to the terminology proposed by the American Clinical Neurophysiology Society.METHODS: In this cohort study, 4 EEG specialists, blinded to outcome, evaluated prospectively recorded EEGs in the Target Temperature Management trial (TTM trial) that randomized patients to 33°C vs 36°C. Routine EEG was performed in patients still comatose after rewarming. EEGs were classified into highly malignant (suppression, suppression with periodic discharges, burst-suppression), malignant (periodic or rhythmic patterns, pathological or nonreactive background), and benign EEG (absence of malignant features). Poor outcome was defined as best Cerebral Performance Category score 3-5 until 180 days.RESULTS: Eight TTM sites randomized 202 patients. EEGs were recorded in 103 patients at a median 77 hours after cardiac arrest; 37% had a highly malignant EEG and all had a poor outcome (specificity 100%, sensitivity 50%). Any malignant EEG feature had a low specificity to predict poor prognosis (48%) but if 2 malignant EEG features were present specificity increased to 96% (p < 0.001). Specificity and sensitivity were not significantly affected by targeted temperature or sedation. A benign EEG was found in 1% of the patients with a poor outcome.CONCLUSIONS: Highly malignant EEG after rewarming reliably predicted poor outcome in half of patients without false predictions. An isolated finding of a single malignant feature did not predict poor outcome whereas a benign EEG was highly predictive of a good outcome.

AB - OBJECTIVE: To identify reliable predictors of outcome in comatose patients after cardiac arrest using a single routine EEG and standardized interpretation according to the terminology proposed by the American Clinical Neurophysiology Society.METHODS: In this cohort study, 4 EEG specialists, blinded to outcome, evaluated prospectively recorded EEGs in the Target Temperature Management trial (TTM trial) that randomized patients to 33°C vs 36°C. Routine EEG was performed in patients still comatose after rewarming. EEGs were classified into highly malignant (suppression, suppression with periodic discharges, burst-suppression), malignant (periodic or rhythmic patterns, pathological or nonreactive background), and benign EEG (absence of malignant features). Poor outcome was defined as best Cerebral Performance Category score 3-5 until 180 days.RESULTS: Eight TTM sites randomized 202 patients. EEGs were recorded in 103 patients at a median 77 hours after cardiac arrest; 37% had a highly malignant EEG and all had a poor outcome (specificity 100%, sensitivity 50%). Any malignant EEG feature had a low specificity to predict poor prognosis (48%) but if 2 malignant EEG features were present specificity increased to 96% (p < 0.001). Specificity and sensitivity were not significantly affected by targeted temperature or sedation. A benign EEG was found in 1% of the patients with a poor outcome.CONCLUSIONS: Highly malignant EEG after rewarming reliably predicted poor outcome in half of patients without false predictions. An isolated finding of a single malignant feature did not predict poor outcome whereas a benign EEG was highly predictive of a good outcome.

U2 - 10.1212/WNL.0000000000002462

DO - 10.1212/WNL.0000000000002462

M3 - Journal article

C2 - 26865516

VL - 86

SP - 1482

EP - 1490

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 16

ER -

ID: 164828001