Outcome prediction by amplitude-integrated EEG in adults with hypoxic ischemic encephalopathy

Introduction: Amplitude-integrated electroencephalography (aEEG) had been widely used in predicting outcome in infants with hypoxic ischemic encephalopathy (HIE). We aimed to evaluate the use of aEEG as a quantitative predictor of outcome in adult patients with HIE. Methods: aEEG and Glasgow coma scale (GCS) were recorded for patients with HIE within 72 h of onset. aEEG traces were categorized as Grade I (normal amplitude): upper margin of aEEG activity >10 mu V, lower margin >5 mu V; Grade II (moderately abnormal amplitude): upper margin of aEEG activity >10 mu V, lower margin <= 5 mu V. or with suppressed amplitude, upper margin <= 10 mu V, lower margin >5 mu V; Grade III (mild abnormality): either upper margin <10 mu V, lower margin <5 mu V. GCS was graded as 1 (9-14), grade II (4-8), or grade III (3). Cerebral performance category scores (CPCs) were determined 1 and 3 month after clinical evolution. CPC 1,2 were defined as favorable outcome; CPC 3,4,5 were considered as poor outcome. Results: 30 cases met inclusion criteria. Both the aEEG grade and GCS scores correlated significantly with short-term outcome, and cases with a worse aEEG grade were more likely to have an unfavorable short-term outcome. Since the number of patients is really too small for long-term outcome analysis, we did not perform the analysis of aEEG, GCS and longer-term outcome. There was significant difference of clinical findings among aEEG classifications, while no statistical difference was found of causes of HIE. Conclusions: aEEG is a reliable predictor of short-term outcome in HIE, and aEEG results within 72 h after onset were associated with neurodevelopmental outcome at 1 mo following clinical evolution. (C) 2011 Elsevier B.V. All rights reserved.