危重症患者脑电图记录潜伏期：对结局的影响。一项随机对照试验（CERTA）的分析。

EEG recording latency in critically ill patients: Impact on outcome. An analysis of a randomized controlled trial (CERTA).

机构信息

Department of Neurology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

Department of Neurology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Department of Neurology, Hôpital du Valais, Sion, Switzerland.

出版信息

Clin Neurophysiol. 2022 Jul;139:23-27. doi: 10.1016/j.clinph.2022.04.003. Epub 2022 Apr 18.

DOI:10.1016/j.clinph.2022.04.003

PMID:35490437

Abstract

OBJECTIVE

To assess, in adults with acute consciousness impairment, the impact of latency between hospital admission and EEG recording start, and their outcome.

METHODS

We reviewed data of the CERTA trial (NCT03129438) and explored correlations between EEG recording latency and mortality, Cerebral Performance Categories (CPC), and modified Rankin Scale (mRS) at 6 months, considering other variables, using uni- and multivariable analyses.

RESULTS

In univariable analysis of 364 adults, median latency between admission and EEG recordings was comparable between surviving (61.1 h; IQR: 24.3-137.7) and deceased patients (57.5 h; IQR: 22.3-141.1); p = 0.727. This did not change after adjusting for potential confounders, such as lower Glasgow Coma Score on enrolment (p < 0.001) and seizure or status epilepticus detection (p < 0.001). There was neither any correlation between EEG latency and mRS (rho 0.087, p 0.236), nor with CPC (rho = 0.027, p = 0.603).

CONCLUSION

This analysis shows no correlation between delays of EEG recordings and mortality or functional outcomes at 6 months in critically ill adults.

SIGNIFICANCE

These findings might suggest that in critically ill adults mortality correlates with underlying brain injury rather than EEG delay.

摘要

目的

评估急性意识障碍成人患者从入院到开始进行脑电图（EEG）记录之间的时间延迟及其对预后的影响。

方法

我们回顾了 CERTA 试验（NCT03129438）的数据，并使用单变量和多变量分析，考虑其他变量，探索了 EEG 记录延迟与死亡率、脑损伤程度（Cerebral Performance Categories，CPC）和 6 个月时改良 Rankin 量表（modified Rankin Scale，mRS）之间的相关性。

结果

在对 364 名成人的单变量分析中，存活患者（中位记录延迟时间为 61.1 h；IQR：24.3-137.7）和死亡患者（中位记录延迟时间为 57.5 h；IQR：22.3-141.1）之间的记录延迟时间中位数无差异（p=0.727）。在调整了潜在混杂因素（如入院时格拉斯哥昏迷评分较低（p<0.001）和癫痫发作或癫痫持续状态的检测（p<0.001）后，这一结果仍未改变。EEG 延迟与 mRS（rho 0.087，p 0.236）或 CPC（rho=0.027，p=0.603）之间也没有相关性。