Department of Neurosurgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China.
Shanghai Institute of Head Trauma, Shanghai, 200127, China.
Neurosci Bull. 2018 Aug;34(4):639-646. doi: 10.1007/s12264-018-0241-7. Epub 2018 Jun 9.
Prognostication of coma patients after brain injury is important, yet challenging. In this study, we evaluated the predictive value of amplitude-integrated electroencephalography (aEEG) for neurological outcomes in coma patients. From January 2013 to January 2016, 128 coma patients after acute brain injury were prospectively enrolled and monitored with aEEG. The 6-month neurological outcome was evaluated using the Cerebral Performance Category Scale. aEEG monitoring commenced at a median of 7.5 days after coma onset. Continuous normal voltage predicted a good 6-month neurological outcome with a sensitivity of 93.6% and specificity of 85.2%. In contrast, continuous extremely low voltage, burst-suppression, or a flat tracing was correlated with poor 6-month neurological outcome with a sensitivity of 76.5% and specificity of 100%. In conclusion, aEEG is a promising predictor of 6-month neurological outcome for coma patients after acute brain injury.
昏迷患者的预后评估非常重要，但也极具挑战性。本研究旨在评估脑损伤后昏迷患者的振幅整合脑电图（aEEG）对神经功能结局的预测价值。2013 年 1 月至 2016 年 1 月，前瞻性纳入了 128 例急性脑损伤后昏迷患者，并使用 aEEG 进行监测。采用脑功能预后量表（Cerebral Performance Category Scale）评估患者 6 个月时的神经功能结局。aEEG 监测在昏迷发生后中位数 7.5 天开始。连续正常电压预测 6 个月时神经功能结局良好的灵敏度为 93.6%，特异性为 85.2%。相反，连续出现极低电压、爆发抑制或平坦波与 6 个月时神经功能结局不良相关，其灵敏度为 76.5%，特异性为 100%。总之，aEEG 是急性脑损伤后昏迷患者 6 个月神经功能结局的一种有前景的预测指标。
