Abstract
Background: Accurate prediction of outcome in hypoxic-ischaemic encephalopathy (HIE) remains a challenge. Multi-channel EEG is not always freely available, leading many to rely on amplitude integrated EEG (aEEG). We wished to examine the correlation between simultaneous EEG and aEEG recordings and their ability to predict 24 month outcome in HIE.
Methods: Continuous EEG was recorded in 46 term infants with HIE. Background EEG activity in one hour epochs was graded at 6, 12, 24 and 48 hours. Neurodevelopmental outcome was measured at 24 months. Simultaneous aEEG was graded by experts blinded to the clinical details, EEG or outcome. Both amplitude based and a pattern recognition grading systems were used and compared.
Results: In 46 recruited infants 125 simultaneous EEG/aEEG recordings were analysed. There was a significant correlation between aEEG and EEG grades (R=0.642, p< 0.001, gamma value = 0.87). Correlation was excellent for normal/mildly abnormal EEGs and isoelectric EEG grades. In the moderate/severe range assigned aEEG grades were on average (SD) -1.54(0.55) and -1.96(0.85) grades below assigned EEG grades respectively. The ability of EEG to predict adverse neurodevelopmental outcome was good with AUROC = 0.87 (0.80-0.94). For aEEG the AUROC was 0.76(0.65-0.86) using amplitude based and 0.79(0.69-0.89) with pattern recognition grading systems.
Conclusions: There is good correlation between expert analysis of aEEG and EEG. Use of aEEG tends to underestimate moderate and severe EEG grades. Prediction of outcome using amplitude based and pattern recognition based aEEG grading were equally reliable, with both being less accurate than multi-channel EEG.
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Murray, D., Lowe, E., O'Rourke, D. et al. 102 A Comparison of Continuous Multi Channel Eeg with Aeeg for the Prediction of Outcome at 24 Months in Hypoxic-Ischaemic Encephalopathy. Pediatr Res 68 (Suppl 1), 54–55 (2010). https://doi.org/10.1203/00006450-201011001-00102
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DOI: https://doi.org/10.1203/00006450-201011001-00102
