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The role of middle latency evoked potentials in early prediction of favorable outcomes among patients with severe ischemic brain injuries

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机构： [1]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China

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关键词： Middle-latency somatosensory evoked potentials Middle-latency auditory evoked potentials Coma Stroke Anoxic-ischemic encephalopathy Outcome prediction

摘要：

Objective: To explore the role of middle latency evoked potentials (EPs) as predictors for favorable outcome in patients with severe ischemic brain injuries by comparing the prognostic ability of short latency somatosensory and auditory evoked potentials (SLSEP and BAEP) with middle latency somatosensory and auditory evoked potentials (MLSEP and MLAEP). Methods: MLSEP, MLAEP, SLSEP and BAEP were recorded in 112 patients with severe ischemic brain injuries (Glasgow Coma Scale <= 8). Among them, 83 patients suffered from cerebral ischemic stroke and 29 suffered from anoxic-ischemic encephalopathy after cardiopulmonary resuscitation between 1 and 7 days after the onset of stroke. Outcomes were reviewed 6 months later using the Glasgow Outcome Scale (GOS). A GOS score of 4-5 was considered as a good outcome while a score of 1-3 was considered as poor. Results: By using the prognostic authenticity analysis of predictors for good outcome, at least unilateral N20 of the SLSEP exit and at least unilateral N60 of the MLSEP exit showed the highest sensitivity which was 100% (95% CI: 86.7%-100%). The bilateral normal N60 showed a high specificity of 97.5% (95% CI: 90.4%-99.6%). It also showed the highest positive likelihood ratio of 625% (95% CI: 1.28%-30.59%), which was superior to N20 of SLSEP, V of BAEP, and Pa of MLAEP. The analysis demonstrated that the area under the curve for MLSEP grading was the highest (0.838) compared to that of SLSEP grading (0.784), MLAEP grading (0.659) and BAEP grading (0.621). Conclusions: Compared with using N20 of SLSEP analysis alone, adding MLSEP improves the outcome prediction in patients with severe ischemic brain injuries. When an outcome is uncertain after initial evaluation using short-latency EPs, MLSEP is valuable to be used from the first week to further improve prognostication in these patients. (C) 2014 Elsevier B.V. All rights reserved.

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出版当年[2013]版：

大类 | 3 区医学

小类 | 4 区临床神经病学 4 区神经科学

最新[2023]版：

大类 | 3 区医学

小类 | 3 区临床神经病学 3 区神经科学

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出版当年[2012]版：

Q2 CLINICAL NEUROLOGY Q3 NEUROSCIENCES

最新[2023]版：

Q1 CLINICAL NEUROLOGY Q2 NEUROSCIENCES

影响因子： 3.7 最新[2023版] 3.2 最新五年平均 2.243 出版当年[2012版] 2.413 出版当年五年平均 2.353 出版前一年[2011版] 2.262 出版后一年[2013版]

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第一作者机构： [1]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China [*1]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.

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通讯机构： [*1]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.

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