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Tytuł pozycji:

EEG spindles integrity in critical care adults. Analysis of a randomized trial.

Tytuł:
EEG spindles integrity in critical care adults. Analysis of a randomized trial.
Autorzy:
Vassallo P; Department of Clinical Neuroscience, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Novy J; Department of Clinical Neuroscience, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Zubler F; Sleep - Wake - Epilepsy - Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Schindler K; Sleep - Wake - Epilepsy - Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Alvarez V; Department of Clinical Neuroscience, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.; Department of Neurology, Hôpital du Valais, Sion, Switzerland.
Rüegg S; Department of Neurology, University Hospital Basel and University of Basel, Basel, Switzerland.
Rossetti AO; Department of Clinical Neuroscience, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Źródło:
Acta neurologica Scandinavica [Acta Neurol Scand] 2021 Dec; Vol. 144 (6), pp. 655-662. Date of Electronic Publication: 2021 Jul 26.
Typ publikacji:
Journal Article; Observational Study; Randomized Controlled Trial
Język:
English
Imprint Name(s):
Publication: Copenhagen : Wiley-Blackwell
Original Publication: Copenhagen Munksgaard
MeSH Terms:
Electroencephalography*
Status Epilepticus*
Adult ; Critical Care ; Humans ; Retrospective Studies ; Seizures
References:
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Grant Information:
2017-00268 Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
Contributed Indexing:
Keywords: coma; critical care; outcome; spindles
Entry Date(s):
Date Created: 20210726 Date Completed: 20211125 Latest Revision: 20220731
Update Code:
20240105
PubMed Central ID:
PMC9290497
DOI:
10.1111/ane.13510
PMID:
34309006
Czasopismo naukowe
Objectives: Occurrence of EEG spindles has been recently associated with favorable outcome in ICU patients. Available data mostly rely on relatively small patients' samples, particular etiologies, and limited variables ascertainment. We aimed to expand previous findings on a larger dataset, to identify clinical and EEG patterns correlated with spindle occurrence, and explore its prognostic implications.
Methods: Retrospective observational study of prospectively collected data from a randomized trial (CERTA, NCT03129438) assessing the relationship of continuous (cEEG) versus repeated routine EEG (rEEG) with outcome in adults with acute consciousness impairment. Spindles were prospectively assessed visually as 12-16Hz activity on fronto-central midline regions, at any time during EEG interventions. Uni- and multivariable analyses explored correlations between spindles occurrence, clinical and EEG variables, and outcome (modified Rankin Scale, mRS; mortality) at 6 months.
Results: Among the analyzed 364 patients, spindles were independently associated with EEG background reactivity (OR 13.2, 95% CI: 3.11-56.26), and cEEG recording (OR 4.35, 95% CI: 2.5 - 7.69). In the cEEG subgroup (n=182), 33.5% had spindles. They had better FOUR scores (p=0.004), fewer seizures or status epilepticus (p=0.02), and lower mRS (p=0.02). Mortality was reduced (p=0.002), and independently inversely associated with spindle occurrence (OR 0.50, CI 95% 0.25-0.99) and increased EEG background continuity (OR 0.16, 95% CI: 0.07 - 0.41).
Conclusions: Besides confirming that spindle activity occurs in up to one third of acutely ill patients and is associated with better outcome, this study shows that cEEG has a higher yield than rEEG in identifying them. Furthermore, it unravels associations with several clinical and EEG features in this clinical setting.
(© 2021 The Authors. Acta Neurologica Scandinavica published by John Wiley & Sons Ltd.)

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