Standardized EEG interpretation accurately predicts prognosis after cardiac arrest

Research output: Contribution to journalArticle

Standard

Standardized EEG interpretation accurately predicts prognosis after cardiac arrest. / Westhall, Erik; Rossetti, Andrea O.; Van Rootselaar, Anne Fleur; Kjaer, Troels Wesenberg; Horn, Janneke; Ullén, Susann; Friberg, Hans; Nielsen, Niklas; Rosén, Ingmar; Aneman, 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 journalArticle

Harvard

Westhall, E, Rossetti, AO, Van Rootselaar, AF, Kjaer, TW, Horn, J, Ullén, S, Friberg, H, Nielsen, N, Rosén, I, Aneman, 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

CBE

Westhall E, Rossetti AO, Van Rootselaar AF, Kjaer TW, Horn J, Ullén S, Friberg H, Nielsen N, Rosén I, Aneman 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. 86(16):1482-1490. https://doi.org/10.1212/WNL.0000000000002462

MLA

Vancouver

Westhall E, Rossetti AO, Van Rootselaar AF, Kjaer TW, 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 ; Kjaer, Troels Wesenberg ; Horn, Janneke ; Ullén, Susann ; Friberg, Hans ; Nielsen, Niklas ; Rosén, Ingmar ; Aneman, 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.

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 - Kjaer, Troels Wesenberg

AU - Horn, Janneke

AU - Ullén, Susann

AU - Friberg, Hans

AU - Nielsen, Niklas

AU - Rosén, Ingmar

AU - Aneman, 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

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.

UR - http://www.scopus.com/inward/record.url?scp=84964345752&partnerID=8YFLogxK

U2 - 10.1212/WNL.0000000000002462

DO - 10.1212/WNL.0000000000002462

M3 - Article

VL - 86

SP - 1482

EP - 1490

JO - Neurology

T2 - Neurology

JF - Neurology

SN - 1526-632X

IS - 16

ER -