Luauté J, Fischer C, Adeleine P, Morlet D, Tell L, Boisson D. Late Auditory and Event-Related Potentials Can Be Useful to Predict Good Functional Outcome After Coma.
Arch Phys Med Rehabil 2005;
86:917-23. [PMID:
15895337 DOI:
10.1016/j.apmr.2004.08.011]
[Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE
To investigate whether late auditory and event-related potentials, and in particular N100 and mismatch negativity, together with clinical parameters, can help to predict good functional outcome in comatose patients.
DESIGN
Prospective cohort study.
SETTING
Hospital.
PARTICIPANTS
Consecutively sampled comatose patients (N=346) whose etiologies of coma were stroke (125 patients), brain injury (96 patients), anoxia (64 patients), complication of neurosurgery (54 patients), and encephalitis (7 patients).
INTERVENTIONS
Not applicable.
MAIN OUTCOME MEASURES
Glasgow Outcome Scale score at 1 year postonset. Patients in a minimally conscious state and those who awoke and died during the follow-up period were classified separately.
RESULTS
Univariate analysis showed that all variables studied, except brainstem auditory evoked potentials, correlated significantly with functional outcome. Mismatch negativity showed the highest positive predictive value for good outcome. A validated model was obtained with multivariate logistic analysis, including pupillary light reflex, N100, mismatch negativity, etiology, and age.
CONCLUSIONS
Late auditory and event-related potentials, and particularly N100 and mismatch negativity, provide strong prognostic factors for good functional outcome. Furthermore, these components may enhance the accuracy of prognosis when associated with other clinical parameters available at the early stage of coma.
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