Predicting Pediatric Cardiac Arrest Outcomes Using Early Quantitative EEG.
Publication/Presentation Date
9-24-2025
Abstract
AIM: Accuracy of neuroprognostication after pediatric cardiac arrest (CA) is critical for directing clinical care. Current limitations include imprecise neuroprognostication models, inability to discriminate between degrees of disability, and lack of modifiable post-CA biomarkers. Models including quantitative EEG (qEEG) characteristics may improve post-CA prognostic accuracy.
METHODS: Retrospective multicenter cohort of children (3mo-18yr) without return to neurologic baseline post-CA at two pediatric tertiary care hospitals (2010-2016) with ≥6-hours of EEG within 24-hours post-CA and baseline Pediatric Cerebral Performance Category (PCPC) 1-3. Primary outcome measure was 6-month PCPC dichotomized into favorable (1-3) and unfavorable (4-6 and Δ>1). Training and validation sets were derived from clinical variables, qualitative EEG (qualEEG) features, and qEEG analysis using Persyst software.
RESULTS: Among 221 subjects, 84 (38%) had favorable 6-month outcomes. All models including clinical features (AUC 0.73 [0.59-0.87]), qualEEG (0.90 [0.81-0.97]) and qEEG features (0.85 [0.74-0.94]) predict outcomes well. A parsimonious model incorporating clinical, qualEEG and qEEG variables had an AUC of 0.92 (0.85-0.97) for predicting outcome. Increased SR was associated with degree of disability and unfavorable outcomes. Machine learning models were not superior to the more transparent parsimonious model.
CONCLUSIONS: qEEG features measured with 24-hours post-CA add to predictive outcome models and can be trended at the bedside. SR is an objective measure that may improve the precision of outcome prediction. qEEG features may be targetable dynamic brain injury biomarkers which could aid in future studies of neuroprotective interventions.
First Page
110838
Last Page
110838
ISSN
1873-1570
Published In/Presented At
Benedetti, G. M., Pardo, A. C., Sanchez-Pinto, L., Straley, M., Wainwright, M. S., Kurz, J. E., & Press, C. A. (2025). Predicting Pediatric Cardiac Arrest Outcomes Using Early Quantitative EEG. Resuscitation, 110838. Advance online publication. https://doi.org/10.1016/j.resuscitation.2025.110838
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
41005642
Department(s)
Department of Pediatrics
Document Type
Article