par Turella, Sara;Dankiewicz, Josef;Ben-Hamouda, Nawfel;Nilsen, Kristian Bernhard;Düring, Joachim;Endisch, Christian;Engstrøm, M.;Flügel, Dominique;Gaspard, Nicolas
;Grejs, Anders;Haenggi, Matthias;Haffey, Stephen;Imbach, Lukas;Johnsen, Birger;Kemlink, David;Leithner, Christoph;Legriel, Stéphane;Lindehammar, Hans;Mazzon, Giulia;Nielsen, Niklas;Peyre, Arnaud;Ribalta Stanford, B.;Roman-Pognuz, E.;Rossetti, Andrea A.O.;Schrag, Claudia
;Valeriánová, Anna;Wendel-Garcia, Pedro David;Zubler, Frédéric;Cronberg, Tobias;Westhall, Erik
Référence Resuscitation, 202, 110319
Publication Publié, 2024-09-01


Référence Resuscitation, 202, 110319
Publication Publié, 2024-09-01
Article révisé par les pairs
Résumé : | Aim: Assess the prognostic ability of a non-highly malignant and reactive EEG to predict good outcome after cardiac arrest (CA). Methods: Prospective observational multicentre substudy of the “Targeted Hypothermia versus Targeted Normothermia after Out-of-hospital Cardiac Arrest Trial”, also known as the TTM2-trial. Presence or absence of highly malignant EEG patterns and EEG reactivity to external stimuli were prospectively assessed and reported by the trial sites. Highly malignant patterns were defined as burst-suppression or suppression with or without superimposed periodic discharges. Multimodal prognostication was performed 96 h after CA. Good outcome at 6 months was defined as a modified Rankin Scale score of 0–3. Results: 873 comatose patients at 59 sites had an EEG assessment during the hospital stay. Of these, 283 (32%) had good outcome. EEG was recorded at a median of 69 h (IQR 47–91) after CA. Absence of highly malignant EEG patterns was seen in 543 patients of whom 255 (29% of the cohort) had preserved EEG reactivity. A non-highly malignant and reactive EEG had 56% (CI 50–61) sensitivity and 83% (CI 80–86) specificity to predict good outcome. Presence of EEG reactivity contributed (p < 0.001) to the specificity of EEG to predict good outcome compared to only assessing background pattern without taking reactivity into account. Conclusion: Nearly one-third of comatose patients resuscitated after CA had a non-highly malignant and reactive EEG that was associated with a good long-term outcome. Reactivity testing should be routinely performed since preserved EEG reactivity contributed to prognostic performance. |