The effect of sedation and time after cardiac arrest on coma outcome prognostication based on EEG power spectra.
Details
Serval ID
serval:BIB_D6A3D5C07CD2
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The effect of sedation and time after cardiac arrest on coma outcome prognostication based on EEG power spectra.
Journal
Brain communications
ISSN
2632-1297 (Electronic)
ISSN-L
2632-1297
Publication state
Published
Issued date
2023
Peer-reviewed
Oui
Volume
5
Number
4
Pages
fcad190
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Publication Status: epublish
Abstract
Early prognostication of long-term outcome of comatose patients after cardiac arrest remains challenging. Electroencephalography-based power spectra after cardiac arrest have been shown to help with the identification of patients with favourable outcome during the first day of coma. Here, we aim at comparing the power spectra prognostic value during the first and second day after coma onset following cardiac arrest and to investigate the impact of sedation on prognostication. In this cohort observational study, we included comatose patients (N = 91) after cardiac arrest for whom resting-state electroencephalography was collected on the first and second day after cardiac arrest in four Swiss hospitals. We evaluated whether the average power spectra values at 4.6-15.2 Hz were predictive of patients' outcome based on the best cerebral performance category score at 3 months, with scores ranging from 1 to 5 and dichotomized as favourable (1-2) and unfavourable (3-5). We assessed the effect of sedation and its interaction with the electroencephalography-based power spectra on patient outcome prediction through a generalized linear mixed model. Power spectra values provided 100% positive predictive value (95% confidence intervals: 0.81-1.00) on the first day of coma, with correctly predicted 18 out of 45 favourable outcome patients. On the second day, power spectra values were not predictive of patients' outcome (positive predictive value: 0.46, 95% confidence intervals: 0.19-0.75). On the first day, we did not find evidence of any significant contribution of sedative infusion rates to the patient outcome prediction (P > 0.05). Comatose patients' outcome prediction based on electroencephalographic power spectra is higher on the first compared with the second day after cardiac arrest. Sedation does not appear to impact patient outcome prediction.
Keywords
Neurology, Cellular and Molecular Neuroscience, Biological Psychiatry, Psychiatry and Mental health, EEG, cardiac arrest, coma, early prognostication, sedation
Pubmed
Web of science
Open Access
Yes
Create date
05/07/2023 15:37
Last modification date
23/01/2024 7:35