Quantitative EEG predicts outcomes in children after cardiac arrest.
Publication/Presentation Date
5-14-2019
Abstract
OBJECTIVE: To determine whether quantitative EEG (QEEG) features predict neurologic outcomes in children after cardiac arrest.
METHODS: We performed a single-center prospective observational study of 87 consecutive children resuscitated and admitted to the pediatric intensive care unit after cardiac arrest. Full-array conventional EEG data were obtained as part of clinical management. We computed 8 QEEG features from 5-minute epochs every hour after return of circulation. We developed predictive models utilizing random forest classifiers trained on patient age and 8 QEEG features to predict outcome. The features included SD of each EEG channel, normalized band power in alpha, beta, theta, delta, and gamma wave frequencies, line length, and regularity function scores. We measured outcomes using Pediatric Cerebral Performance Category (PCPC) scores. We evaluated the models using 5-fold cross-validation and 1,000 bootstrap samples.
RESULTS: The best performing model had a 5-fold cross-validation accuracy of 0.8 (0.88 area under the receiver operating characteristic curve). It had a positive predictive value of 0.79 and a sensitivity of 0.84 in predicting patients with favorable outcomes (PCPC score of 1-3). It had a negative predictive value of 0.8 and a specificity of 0.75 in predicting patients with unfavorable outcomes (PCPC score of 4-6). The model also identified the relative importance of each feature. Analyses using only frontal electrodes did not differ in prediction performance compared to analyses using all electrodes.
CONCLUSIONS: QEEG features can standardize EEG interpretation and predict neurologic outcomes in children after cardiac arrest.
Volume
92
Issue
20
First Page
2329
Last Page
2329
ISSN
1526-632X
Published In/Presented At
Lee, S., Zhao, X., Davis, K. A., Topjian, A. A., Litt, B., & Abend, N. S. (2019). Quantitative EEG predicts outcomes in children after cardiac arrest. Neurology, 92(20), e2329–e2338. https://doi.org/10.1212/WNL.0000000000007504
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
30971485
Department(s)
Department of Pediatrics
Document Type
Article