Neurophysiology and neuroimaging accurately predict poor neurological outcome within 24 hours after cardiac arrest: The ProNeCA prospective multicentre prognostication study

To investigate the ability of 30-min electroencephalogram (EEG), short-latency somatosensory evoked potentials (SEPs) and brain computed tomography (CT) to predict poor neurological outcome (persistent vegetative state or death) at 6 months in comatose survivors of cardiac arrest within 24 h from th...

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Published in:Resuscitation 2019-10, Vol.143, p.115-123
Main Authors: Scarpino, Maenia, Lolli, Francesco, Lanzo, Giovanni, Carrai, Riccardo, Spalletti, Maddalena, Valzania, Franco, Lombardi, Maria, Audenino, Daniela, Celani, Maria Grazia, Marrelli, Alfonso, Contardi, Sara, Peris, Adriano, Amantini, Aldo, Sandroni, Claudio, Grippo, Antonello, Masi, Giulia, Moretti, Marco, Bandinelli, Chiara, Marudi, Andrea, Rikani, Klaudio, Ospedale Galliera, E.O., Cantisani, Teresa Anna, Fiacca, Andrea, Sabadini, Rossella
Format: Article
Language:English
Subjects:
Anoxia-ischemia
Brain
Cardiac arrest
Coma
Computed tomography
Electroencephalogram
Prognosis
Somatosensory evoked potentials
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Summary:To investigate the ability of 30-min electroencephalogram (EEG), short-latency somatosensory evoked potentials (SEPs) and brain computed tomography (CT) to predict poor neurological outcome (persistent vegetative state or death) at 6 months in comatose survivors of cardiac arrest within 24 h from the event. Prospective multicentre prognostication study in seven hospitals. SEPs were graded according to the presence and amplitude of their cortical responses, EEG patterns were classified according to the American Clinical Neurophysiology Society terminology and brain oedema on brain CT was measured as grey/white matter (GM/WM) density ratio. Sensitivity for poor outcome prediction at 100% specificity was calculated for the three tests individually and in combination. None of the patients underwent withdrawal of life-sustaining treatments before the index event occurred. A total of 346/396 patients were included in the analysis. At 6 months, 223(64%) had poor neurological outcome; of these, 68 were alive in PVS. Bilaterally absent/absent-pathological amplitude cortical SEP patterns, a GM/WM ratio
ISSN:0300-9572
1873-1570
DOI:10.1016/j.resuscitation.2019.07.032