Abstracts

Rationale: Continuous video electroencephalography recording (CEEG) is often used as one of the non-invasive methods for prognostication in comatose patients after cardiac arrest (CA). However, the value of CEEG in this patient population is controversial. The aim of this study was to assess the utility of CEEG in prognosis of post CA patients. Methods: Retrospective chart review was performed on patients who had CA between January 1, 2018, and June 30, 2018, and underwent CEEG at our hospital. Demographics and clinical data were collected on each patient. Multiple variables were analyzed including presence of clinical seizures and electrographic features on EEG, co-morbidities, duration of downtime after CA, sedation and number of anti-seizure drugs (ASD) used to treat the patients and pre and post modified Rankin score. Fisher’s exact tests and two sample t-tests were used to compare the patient groups with high mortality and survivors. Results: A total of 19 patients [14/19 (74%) male] were included with a mean age of 57.9 years (range 30-90 years). CEEG features showed background slowing or generalized periodic discharges with triphasic morphology in 53%, lateralized periodic discharges (LPDS), quasi-LPDs/ Stimulus Induced Rhythmic, Periodic or Ictal Discharges (SIRPIDs), sharps/spike and wave discharges in 26%, clinical status epilepticus in 11% and non-epileptic spells in 11%. Forty two percent of patients had recurrent myoclonus, jerks or witnessed seizures. CEEG findings led to change in treatment in 68% of patients who all received both sedation and ASDs. Almost half of these (47%) were diagnosed with hypoxic/anoxic brain injury and 79% had sepsis, or metabolic/hepatic/renal abnormalities. A total of 14 patients (74%) died in the hospital with 12 having proximate cause of death from withdrawal of care, 1 from brain death and 1 from other reasons. Out of the 5 patients who survived post CA, 2 were discharged home and 3 were discharged to rehab. There were no differences in the CEEG findings and duration of downtime after CA that were detected between the high mortality and the survivors groups. Conclusions: This study shows that CEEG findings led to change in the treatment in the majority of patients post CA. However, it appears that its use and impact on treatment did not alter the overall prognosis given the outcomes in the population we studied. Prognosis of patients post CA is poor, and majority of these patients undergo withdrawal of care. Small sample size is a limitation of our retrospective study. Prospective studies with larger population sample are warranted to further address the utility and cost effectiveness of CEEG in the overall prognosis of patients after CA. Sources of Funding: Not Applicable Funding: No funding