[Coma. The prognostic value of evoked potentials in patients after traumatic brain injury].

BACKGROUND

The prognosis after traumatic coma is often unclear. We investigated the prognostic value of somatosensory (SSEP) and early acoustic (EAEP) evoked potentials on comatose patients in the intensive care unit regarding long-term outcome. Different evaluation systems were investigated.

METHODS

This was a retrospective analysis of 100 patients. SSEP and EAEP were examined at different times and analysed according to the Riffel score. Combinations of the different types of potentials were evaluated regarding possible improvement of outcome prediction.

RESULTS

The positive predictive value of at least one missing peak V of the EAEP regarding a fatal prognosis was 83%. The negative predictive value of the EAEP was 96%. A good outcome (GOS 4+5) could be predicted by bilateral normal SSEP and EAEP with a positive predictive value of 98%.

CONCLUSIONS

Early evaluation of SSEP and EAEP allows reliable prognostic predictions regarding a later outcome in patients with severe traumatic brain injury and should therefore be used more often for intensive care patients.