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EEG and Clinical Associations With Mortality in Comatose Patients in a General Intensive Care Unit

Young, G. Bryan; Kreeft, John H.*; McLachlan, Richard S.; Demelo, Janet

Journal of Clinical Neurophysiology: July 1999 - Volume 16 - Issue 4 - pp 354-360
Nonconvulsive Status Epilepticus: Original Contributions

The authors examined EEG findings and clinical factors for their association with outcome in comatose patients in their general intensive care unit. The following individual and combinations of factors were strongly related to mortality, with positive predictive values of >0.80 and odds ratios >2.0: age over 65 years, anoxic/ischemic encephalopathy, EEG suppression, lack of EEG reactivity; anoxia-ischemia with partial or complete cranial nerve areflexia, anoxia-ischemia with EEG suppression; anoxia-ischemia and generalized epileptiform activity; anoxia-ischemia with partial cranial nerve areflexia and EEG suppression. Conversely, the following factors favored survival rather than death: systemic infection/sepsis, metabolic derangement (excluding anoxic-ischemic insult), trauma; dysrhythmia, focal epileptiform activity, and regional delta and reactivity on EEGs. The findings of this study support the integration of these data into intensive care unit prognostic scoring systems, such as later versions of the Acute Physiology and Chronic Health Evaluation (APACHE).

Departments of Clinical Neurological Sciences and *Medicine, University of Western Ontario, London, Ontario, Canada

Address correspondence and reprint requests to Dr. G. B. Young, Department of Clinical Neurological Sciences, London Health Sciences Centre, 375 South Street, London, Ontario, Canada N6A 4G5.

Copyright © 1999 American Clinical Neurophysiology Society