Stimulus-induced EEG-patterns and outcome after cardiac arrest

N. Jaffer Broman, S. Backman, E. Westhall

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: EEG is commonly used to predict prognosis in post anoxic coma. We investigated if stimulus-induced rhythmic, periodic or ictal discharges (SIRPIDs) add prognostic information after cardiac arrest. Methods: In the multicenter Targeted Temperature Management trial, routine-EEGs were prospectively recorded after rewarming (≥36 h). Presence and subtype of SIRPIDs and main EEG-pattern (benign, malignant, highly malignant) were retrospectively reported according to a standardised classification. Patients were followed up after 180 days. Poor outcome was defined as severe neurological disability or death (Cerebral Performance Category 3–5). Results: Of 142 patients, 71% had poor outcome and 14% had SIRPIDs. There was no significant difference in outcome between patients with and without SIRPIDs, even when subgrouped according to underlying main EEG-pattern. Comparing subtypes of SIRPIDs, 82% of patients with stimulus-induced periodic discharges had poor outcome compared to 44% of patients with stimulus-induced rhythmic delta activity, but the difference was not significant. Conclusions: In EEGs performed ≥36 h after cardiac arrest, SIRPIDs cannot be used to reliably predict poor outcome. Whether certain subtypes of SIRPIDs indicate worse prognosis needs further investigation. Significance: Categorising the main EEG-pattern has important prognostic implications, but assessment of late appearing SIRPIDs does not seem to add prognostic information.

Original languageEnglish
Pages (from-to)219-224
Number of pages6
JournalClinical Neurophysiology Practice
Volume6
DOIs
Publication statusPublished - 2021 Jan

Subject classification (UKÄ)

  • Neurology

Free keywords

  • Cardiac arrest
  • Coma
  • EEG
  • Prognosis
  • SIRPIDs

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