Electroencephalography as a Predictor of Mortality and Short-term Functional Outcome in Children in Intensive Care Unit
Abstract number :
2.020
Submission category :
3. Neurophysiology / 3B. ICU EEG
Year :
2016
Submission ID :
195536
Source :
www.aesnet.org
Presentation date :
12/4/2016 12:00:00 AM
Published date :
Nov 21, 2016, 18:00 PM
Authors :
Ara Ko, Department of Pediatrics, Division of Pediatric Neurology, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; In Sook Sol, Department of Pediatrics, Division of Pediatric Pulmonology and Allergy, Severa
Rationale: The utility of electroencephalogram (EEG) as one of predictors for mortality and outcome in intensive care unit (ICU) patients has been highlighted recently. Azabou et al. showed that absence of EEG reactivity, delta-premoninant background, periodic discharges are independent predictors of ICU mortality in an adult study (PLoS One 2015; 10(10): e0139969). In a pediatric study, it was shown that electrographic status epilepticus is associated with mortality and worse short-term and long-term outcome in pediatric ICU patients (Crit Care Med 2013; 41(1): 215-23, Neurology 2014; 82(5): 396-404). We hypothesized that the EEG findings other than electrographical status epilepticus would predict mortality and functional outcome of the children who were admitted to the ICU. Methods: We reviewed EEGs of 209 pediatric patients, aged less than 19 years old, who received EEGs in the ICU for various reasons at Severance Hospital between January 2012 and December 2015. To determine the functional outcome, we used pediatric overall performance category (POPC) scale, a tool developed to assess the outcome of pediatric intensive care (J Pediatr 1992; 121(1): 68-74). Data are expressed in median (interquartile range [IQR]). Results: Median age of the patients at the time of the EEG study was 1.9 (0.8-6.2) years old. Of 209, 117 were male; 104 patients had an underlying neurologic diagnosis, and 61 patients died. Median duration of the ICU stay was 14 days (7-30). The median interval to performing EEG since ICU admission was 2 days (1-6). EEG was normal in 47 patients; abnormal with severely attenuated background in 57 patients; and abnormal with some epileptiform discharges in 105 patients. Patients who showed abnormal EEG findings were more likely to die (6.4% vs 35.8%, p < 0.001), and to have worse functional outcome as in change in POPC (p < 0.001). Conclusions: EEG abnormalities are associated with increased mortality and worse functional outcome in children who are admitted to the ICU. Funding: The authors have no funding to report.
Neurophysiology