Predictive Value Of Modified CARFS EEG Score For The Severity Of Brain Injury In Premature Infants

Objective:Explore the correlation between modified CARFS EEG score and acute-stage abnormality(ASA)EEG score and the severity of brain injury in preterm infants,and compare the predictive value of two evaluation methods for the severity of brain injury in preterm infants.Methods:Preterm infants with gestational age≤32 weeks admitted to the second neonatal unit of Shengjing Hospital Affiliated to China Medical University from January2018 to February 2023 were retrospectively included,who received continuous video EEG(c VEEG)monitoring and evaluation at least once within 7 days after birth,completed magnetic resonance imaging(MRI)or cerebral ultrasounds(c US)examination before discharge,and were diagnosed as periventricular leucomalacia(PVL)and/or intraventricular hemorrhage(IVH).The modified CARFS EEG score and ASA EEG score were used to evaluate the electrical activity of the brain,to explore the correlation between the two evaluation methods and the severity of brain injury in premature infants,and to compare the prediction value of the two evaluation methods for the severity of brain injury in premature infants.Results:Among the 40 subjects,55%(22/40)had mild brain damage and 45%(18/40)had severe brain damage.1.The median of modified CARFS EEG score and ASA EEG score in the severe brain injury group were 9.0(6.0,14.5)and 3.0(3.0,5.0),while the median of modified CARFS EEG score and ASA EEG score in the mild brain injury group were 3.0(1.0,7.0)and 2.0(0.0,3.0),with statistical significance(P<0.05).2.The modified CARFS EEG score and ASA EEG score were linearly positively correlated with the severity of brain injury in preterm infants,and the modified CARFS EEG score was more significantly correlated(r_sof modified CARFS EEG score was 0.583,r_sof ASA EEG score was 0.513,P<0.001).3.Both of the two EEG evaluation methods had good predictive value for the severity of premature brain injury.The area under ROC curve of the modified CARFS EEG scoring method was 0.836,with a specificity of 90.9%and a critical value of 7.5.ASA EEG classification method had an area under ROC curve of0.789,a specificity of 59.1%and a critical value of 2.5.Conclusions:Both the modified CARFS EEG score and ASA EEG score have good correlation with the severity of premature brain injury,and the predictive value and specificity of the modified CARFS EEG score are better than ASA EEG score.The modified CARFS EEG score of more than 7 and ASA EEG score of more than II were highly suggestive of severe brain injury.