Abstract
Background Conventional electroencephalography (EEG) may help predict outcome in preterm infants, but requires specialist interpretation. Some cotside EEG devices provide quantitative analyses assisting non-specialists with interpretation.
Aim to compare quantitative measures of continuity with interpretation by a neurophysiologist using early cotside EEG recordings to predict outcome of preterm infants.
Methods in infants <32 weeks gestation 60 minute epochs of EEG recorded using research BRM cotside monitors (BrainZ Instruments Ltd, Auckland, New Zealand) were analysed for continuity (percentage of each minute with EEG amplitude >10μV) and categorised as normal (100%, 62% of cohort), moderate (80–99%) or low (<80%, lowest 10% of cohort). The same portion of EEG was graded by a neurophysiologist, blinded to infant outcome, as 'normal' or 'abnormal' using interburst interval and seizure activity. Surviving infants had Bayley-II examinations at 18 months. Outcome was 'poor' if the infant died or had a Mental or Psychomotor Developmental Index (MDI/PDI) <70, 'moderate' if MDI or PDI=70–84, and 'normal' if MDI and PDI>=85.
Results Analyses were performed for 29 infants with median (range) gestation at delivery 26(24–31)weeks, birthweight 910(605–1250)grams and postnatal age at EEG 22(2–53)hours. Outcomes were 'poor' in 7 (3 died, 4 had PDI<70), 'moderate' in 8 and 'normal' in 14. Three infants with low continuity had 'poor' outcome. Moderate continuity was found in 2/7 infants with 'poor' outcome, 3/8 infants with 'moderate' outcome and 5/14 with 'normal' outcome. The remainder had normal continuity (Cramer's V=0.43, Chi-squared p=0.03). The neurophysiologist graded traces as abnormal in 6/7 infants with 'poor' outcome, 1/8 with 'moderate' and 0/14 with 'normal' outcome (Cramer's V=0.82, Chi-squared p<0.0001). Categorisation by continuity measures and neurophysiologist assessment were dissimilar, Chi-squared p=0.19.
Conclusion Both techniques offer some potential, but continuity measures performed less well than neurophysiologist interpretation in predicting outcome from early cotside EEG recordings. MB is a consultant for BrainZ Instruments Ltd.
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West, C., Nolan, M., Williams, C. et al. 414 Comparison of Quantitative Measures and Neurophysiologist Assessment Using Cotside EEG Monitors to Predict Outcome in Preterm Infants. Pediatr Res 58, 425 (2005). https://doi.org/10.1203/00006450-200508000-00443
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DOI: https://doi.org/10.1203/00006450-200508000-00443