%0 Journal Article
%T EEG for good outcome prediction after cardiac arrest: A multicentre cohort study.
%A Turella S
%A Dankiewicz J
%A Ben-Hamouda N
%A Bernhard Nilsen K
%A Düring J
%A Endisch C
%A Engstrøm M
%A Flügel D
%A Gaspard N
%A Grejs AM
%A Haenggi M
%A Haffey S
%A Imbach L
%A Johnsen B
%A Kemlink D
%A Leithner C
%A Legriel S
%A Lindehammar H
%A Mazzon G
%A Nielsen N
%A Peyre A
%A Ribalta Stanford B
%A Roman-Pognuz E
%A Rossetti AO
%A Schrag C
%A Valeriánová A
%A Wendel-Garcia P
%A Zubler F
%A Cronberg T
%A Westhall E
%A  
%J Resuscitation
%V 0
%N 0
%D 2024 Jul 17
%M 39029579
%F 6.251
%R 10.1016/j.resuscitation.2024.110319
%X <B>OBJECTIVE: </B>Assess the prognostic ability of a non-highly malignant and reactive EEG to predict good outcome after cardiac arrest (CA).<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.