Early Quantitative EEG Variables as Non-dichotomous Predictors of Long Term Outcomes After Pediatric Cardiac Arrest
Abstract number :
1.113
Submission category :
2. Translational Research / 2C. Biomarkers
Year :
2022
Submission ID :
2204386
Source :
www.aesnet.org
Presentation date :
12/3/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:24 AM
Authors :
Craig Press, MD, PhD – Children's Hospital of Philadelphia; Giulia Benedetti, MD – University of Washington School of Medicine; Megan Straley, PhD, RN – Children's Hospital Colorado; Andrea Pardo, MD – Ann & Robert H. Lurie Children's Hospital of Chicago; L Nelson Sanchez-Pinto, MD, MBI – Ann & Robert H. Lurie Children's Hospital of Chicago; Mark Wainwright, MD, PhD – University of Washington School of Medicine; Jonathan Kurz, MD, PhD – Ann & Robert H. Lurie Children's Hospital of Chicago
Rationale: Qualitative features and categorized quantitative measures have been shown to improve prediction of outcomes after pediatric cardiac arrest. We aimed to determine if quantitative EEG (qEEG) features can predict outcome after pediatric cardiac arrest (CA) as linear rather than categorical features.
Methods: We performed a multicenter retrospective study of children aged ≥3 months-18 years with baseline Pediatric Cerebral Performance Category (PCPC) ≤3 with ≥6 hours of EEG within 24 hours of CA. The primary outcome was PCPC at 6 months. qEEG values included relative frequency band power, total power, alpha/delta (ADR) and theta/delta (TDR) ratios, suppression ratio (SR), spectral edge frequency (SEF), and peak envelope and were normalized with published age based normative values. Patients with a suppression ratio ≤10 were analyzed separately. The non-parametric Kruskal-Wallis test was utilized for the analysis.
Results: A total of 225 patients were included in the initial analysis of the suppression ratio (SR) and outcomes. SRs of ≤1%, 1-5%, and 5-10% were associated with a normal outcome (PCPC =1) in 35%, 12% and 7% of patients. No patient was normal at 6 months with a SR >10% (Figure 1). For the 136 patients with a SR ≤10% the quantitative features that predicted outcomes included: relative delta, alpha, beta, gamma, SEF 50%, SEF 95%, SR, ADR and TDR (p< 0.01) (Figure 2). Median values for relative delta increased as outcomes worsened, while all other variables examined declined with increased disability at six months. Relative alpha, beta, gamma, and ADR had a steady decline while relative delta, SEF 95%, and theta delta had a more dichotomous appearance with favorable compared to unfavorable outcomes.
Translational Research