Al-Said Youssef A, Baeesa Saleh S, Shivji Zaitoon, Kayyali Husam, Alqadi Khalid, Kadi Ghada, Cupler Edward J, Abuzinadah Ahmad R
Department of Neurosciences, King Faisal Specialist Hospital, and Research Center, Jeddah, Saudi Arabia.
Department of Neurosciences, King Faisal Specialist Hospital, and Research Center, Jeddah, Saudi Arabia; Division of Neurosurgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Clin Neurol Neurosurg. 2018 Aug;171:95-99. doi: 10.1016/j.clineuro.2018.06.002. Epub 2018 Jun 5.
Electroencephalography (EEG) in the intensive care unit (ICU) is often done to detect non-convulsive seizures (NCS). The outcome of ICU patients with NCS strongly depends on the underlying etiology. The implication of NCS and other EEG findings on clinical outcome independent from their etiology is not well understood and our aim to investigate it.
We retrospectively identified all adult patients in the ICU who underwent EEG monitoring between January 2008 and December 2011. The main goals were to define the rate of NCS or non-convulsive status epilepticus (NCSE) occurrence in our center among patients who underwent EEG monitoring and to examine if NCS/NCSE are associated with poor outcome [defined as death or dependence] with and without adjustment for underlying etiology. The rate of poor outcome among different EEG categories were also investigated.
During the study period, 177 patients underwent EEG monitoring in our ICU. The overall outcome was poor in 62.7% of those undergoing EEG. The rate of occurrence of NCS/NCSE was 8.5% and was associated with poor outcome in 86.7% with an odds ratio (OR) of 5.1 (95% confidence interval [CI] 1.09-23.8). This association was maintained after adjusting for underlying etiologies with OR 5.6 (95% CI 1.05-29.6). The rate of poor outcome was high in the presence of periodic discharges and sharp and slow waves of 75% and 61.5%, respectively.
Our cohort of ICU patients undergoing EEGs had a poor outcome. Those who developed NCS/NCSE experienced an even worse outcome regardless of the underlying etiology.
在重症监护病房（ICU）进行脑电图（EEG）检查通常是为了检测非惊厥性癫痫发作（NCS）。患有NCS的ICU患者的预后很大程度上取决于潜在病因。NCS及其他EEG检查结果对临床预后的影响（独立于其病因）尚未得到充分理解，我们旨在对此进行研究。
我们回顾性确定了2008年1月至2011年12月期间在ICU接受EEG监测的所有成年患者。主要目的是确定在我们中心接受EEG监测的患者中NCS或非惊厥性癫痫持续状态（NCSE）的发生率，并检查NCS/NCSE是否与不良预后[定义为死亡或依赖]相关，同时对潜在病因进行或不进行校正。我们还研究了不同EEG类别中不良预后的发生率。
在研究期间，我们ICU中有177例患者接受了EEG监测。接受EEG检查的患者中，总体预后不良的比例为62.7%。NCS/NCSE的发生率为8.5%，86.7%的患者预后不良，优势比（OR）为5.1（95%置信区间[CI] 1.09 - 23.8）。在对潜在病因进行校正后，这种关联仍然存在，OR为5.6（95% CI 1.05 - 29.6）。出现周期性放电和尖慢波时，不良预后的发生率分别高达75%和61.5%。
我们这组接受EEG检查的ICU患者预后不良。发生NCS/NCSE的患者，无论潜在病因如何，预后更差。
