EEG and clinical associations with mortality in comatose patients in a general intensive care unit

The authors examined EEG findings and clinical factors for their associatio n with outcome in comatose patients in their general intensive care unit. T he following individual and combinations of factors were strongly related t o mortality, with positive predictive values of >0.80 and odds ratios >2.0: age over 65 years, anoxic/ischemic encephalopathy, EEG suppression, lack o f EEG reactivity; anoxia-ischemia with partial or complete cranial nerve ar eflexia, anoxia-ischemia with EEG suppression; anoxia-ischemia and generali zed epileptiform activity; anoxia-ischemia with partial cranial nerve arefl exia and EEG suppression. Conversely, the following factors favored surviva l rather than death: systemic infection/sepsis, metabolic derangement (excl uding anoxic-ischemic insult), trauma; dysrhythmia, focal epileptiform acti vity, and regional delta and reactivity on EEGs. The findings of this study support the integration of these data into intensive care unit prognostic scoring systems, such as later versions of the Acute Physiology and Chronic Health Evaluation (APACHE).