Electromyographic reactivity measured with scalp-EEG contributes to prognostication after cardiac arrest.

Caporro, Matteo; Rossetti, Andrea O; Seiler, Andrea; Kustermann, Thomas; Nguepnjo Nguissi, Nathalie Ata; Pfeiffer, Christian; Zimmermann, Rebekka; Hänggi, Matthias; Oddo, Mauro; De Lucia, Marzia; Zubler, Frédéric (2019). Electromyographic reactivity measured with scalp-EEG contributes to prognostication after cardiac arrest. Resuscitation, 138, pp. 146-152. Elsevier Science Ireland 10.1016/j.resuscitation.2019.03.014

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AIM

To assess whether stimulus-induced modifications of electromyographic activity observed on scalp EEG have a prognostic value in comatose patients after cardiac arrest.

METHODS

184 adult patients from a multi-centric prospective register who underwent an early EEG after cardiac arrest were included. Auditory and somatosensory stimulation was performed during EEG-recording. EEG reactivity (EEG-R) and EMG reactivity (EMG-R) were retrospectively assessed visually by board-certified electroencephalographers, and compared with clinical outcome (cerebral performance category, CPC) at three months. A favorable functional outcome was defined as CPC 1-2, an unfavorable outcome as CPC 3-5.

RESULTS

Both EEG-R and EMG-R were predictors for good outcome (EEG-R accuracy 72% (95%-CI 66-79), sensitivity 86% (78-93), specificity 60% (50-69); EMG-R accuracy 65% (58-72), sensitivity 61% (51-75), specificity 69% (60-78)). When reactivity was defined as EEG-R and/or EMG-R, the accuracy was 73% (67-70), the sensitivity 94% (90-99), and the specificity 53% (43-63).

CONCLUSION

Taking EMG into account when assessing reactivity of EEG seems to reduce false negative predictions for identifying patients with favorable outcome after cardiac arrest.

Interest & Impact

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