Standardized EEG Analysis to Reduce the Uncertainty of Outcome Prognostication After Cardiac Arrest
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In the majority of comatose cardiac arrest (CA) patients, the outcome remains indeterminate after application of ERC/ESICM prognostication algorithm. Standardized EEG background analysis enables accurate prediction of both good and poor recovery, thereby greatly reducing uncertainty about coma prognostication in this patient population.
Using the ERC/ESICM algorithm, 155 (32%) patients were prognosticated with poor outcome; all died at 3 months.
Among the remaining 330 (68%) patients with an indeterminate outcome, the majority (212/330; 64%) showed good recovery.
In this patient subgroup, absence of a highly malignant EEG by day 3 had 99.5 [97.4–99.9] % sensitivity for good recovery, which was superior to NSE < 33 μg/L. A prospective cohort of comatose CA patients was examined in whom the ERC/ESICM algorithm was applied.