Reduced EEG montage has a high accuracy in the post cardiac arrest setting
Copyright © 2020 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved..
OBJECTIVE: To study if comatose cardiac arrest patients can be assessed with a reduced number of EEG electrodes.
METHODS: 110 routine EEGs from 67 consecutive patients, including both hypothermic and normothermic EEGs were retrospectively assessed by three blinded EEG-experts using two different electrode montages. A standard 19-electrode-montage was compared to the reduced version of the same EEGs, down-sampled to six electrodes (F3, T3, P3, F4, T4, P4). We used intra-rater and inter-observer statistics to assess the reliability of the reduced montage for background features and discharges.
RESULTS: The reduced montage had almost perfect performance for background continuity (κ 0.80-0.88), including identification of highly malignant backgrounds (burst-suppression/suppression) (κ 0.85-0.94) and benign backgrounds (continuous/nearly continuous) (κ 0.85-0.91). We found substantial performance for identifying rhythmic/periodic discharges (κ 0.79-0.86). The reduced montage had high accuracy for assessment of both highly malignant (sensitivity 91-95%, specificity 94-99%) and benign (sensitivity 89-98%, specificity 91-96%) backgrounds, and periodic/rhythmic patterns (sensitivity 79-100%, specificity 89-99%), compared to the full montage. The inter-observer variability was not increased by the reduced montage.
CONCLUSION: Reduced EEG had high performance for classifying important background and discharge patterns in this post cardiac arrest cohort.
SIGNIFICANCE: Our results support the use of reduced EEG-montage for monitoring comatose cardiac arrest patients.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:131 |
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| Enthalten in: |
Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology - 131(2020), 9 vom: 21. Sept., Seite 2216-2223 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Backman, Sofia [VerfasserIn] |
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| Links: |
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| Themen: |
Cardiac arrest |
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| Anmerkungen: |
Date Completed 25.05.2021 Date Revised 25.05.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.clinph.2020.06.021 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM312872852 |
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| 500 | |a Date Revised 25.05.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved. | ||
| 520 | |a OBJECTIVE: To study if comatose cardiac arrest patients can be assessed with a reduced number of EEG electrodes | ||
| 520 | |a METHODS: 110 routine EEGs from 67 consecutive patients, including both hypothermic and normothermic EEGs were retrospectively assessed by three blinded EEG-experts using two different electrode montages. A standard 19-electrode-montage was compared to the reduced version of the same EEGs, down-sampled to six electrodes (F3, T3, P3, F4, T4, P4). We used intra-rater and inter-observer statistics to assess the reliability of the reduced montage for background features and discharges | ||
| 520 | |a RESULTS: The reduced montage had almost perfect performance for background continuity (κ 0.80-0.88), including identification of highly malignant backgrounds (burst-suppression/suppression) (κ 0.85-0.94) and benign backgrounds (continuous/nearly continuous) (κ 0.85-0.91). We found substantial performance for identifying rhythmic/periodic discharges (κ 0.79-0.86). The reduced montage had high accuracy for assessment of both highly malignant (sensitivity 91-95%, specificity 94-99%) and benign (sensitivity 89-98%, specificity 91-96%) backgrounds, and periodic/rhythmic patterns (sensitivity 79-100%, specificity 89-99%), compared to the full montage. The inter-observer variability was not increased by the reduced montage | ||
| 520 | |a CONCLUSION: Reduced EEG had high performance for classifying important background and discharge patterns in this post cardiac arrest cohort | ||
| 520 | |a SIGNIFICANCE: Our results support the use of reduced EEG-montage for monitoring comatose cardiac arrest patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Cardiac arrest | |
| 650 | 4 | |a Coma | |
| 650 | 4 | |a EEG monitoring | |
| 650 | 4 | |a Montage | |
| 650 | 4 | |a Postanoxic encephalopathy | |
| 700 | 1 | |a Cronberg, Tobias |e verfasserin |4 aut | |
| 700 | 1 | |a Rosén, Ingmar |e verfasserin |4 aut | |
| 700 | 1 | |a Westhall, Erik |e verfasserin |4 aut | |
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