The Early Prediction Of Prognosis In Patient With Severe Brain Impairment Using L-eeg United Baep

Objective: Using Long-term electroencephalogram (L-EEG) combined with brain-stem auditory evoked potential predicts early the prognosis in patients with severe brain impairment and compares the prognosis assessment with Glasgow Coma Scale (GCS) to evaluate its early prediction of the prognosis of patients with severe brain impairment.Methods: To choose the patients with severe brain impairment from September 2008 to March 2010 in our hospital as a research object, a total of 40 cases, 26 cases were males and 14 females, aged from 17 to 92 years old with an average age of 62.56±11.23 years old. All cases of severe brain damage occured acutely and appeared quickly conscious disturbance within 1 week.the clinical diagnosis were system checked. First, check up the patients with clinical comprehensive examination and GCS, Include moderate and severe brain damage patients (GCS score<12 points)in the study object, and then using Kangtai CMS-2000-type dynamic electroencephalogram monitors and keypoint 4 electromyogram evoked potentials produced by Medtronic monitor respectively L-EEG and BAEP. Classify the monitoring results referring Synek and Hall and predict the prognosis of patients. Using Glasgow Outcome Scale (GOS) assessed clinical outcomes. The end time of assessing is after 3 months. Analyzing comprehensively the research findings to compared the accuracy of different electrophysiological examination methods with GCS in early prediction of the prognosis of patients with severe brain impairment and analyzed the relationship between L-EEG and BAEP classification and clinical prognosis.Results: 1 GOS assessment A total of 40 cases included GOS 1(death) 5 cases, GOS 2(vegetative state ) 8 cases, GOS 3(severe disability) 13 cases, GOS 4(moderate disability)9 cases and GOS 5(recover) 5 cases. 2 GCS and clinical prognosis. fifteen cases of indices were good( 9 patients with good prognosis, six patients with poor prognosis), twenty-five cases were negative indicators( 20 patients with poor prognosis, 5 patients with good prognosis). The sensitivity, specificity, and comprehensive prediction accuracy rates were 76.9%, 64.3% and 72.5%. 3 L-EEG and clinical prognosis forteen cases of indices were good( 11 patients with good prognosis, 3 patients with a poor prognosis), twenty-six cases were negative indicators (23 patients with poor prognosis, 3 patients with good prognosis). The sensitivity, specificity, and integrated forecasting accuracy rates were 88.5%, 84.6% and 85.0%. 4 BAEP and clinical prognosis fifteen cases of indices were good( 10 patients with good prognosis, 5 patients with poor prognosis), twenty-five cases were negative indicators(21 patients with poor prognosis; 4 patients with good prognosis). The sensitivity, specificity and overall accuracy rate of prediction were 80.8%, 71.4% and 77.5%. 5 L-EEG combined with BAEP and Clinical prognosis forteen cases of indices were good( 12 patients with good prognosis, 2 patients with poor prognosis), twenty-six cases were poor indicators ( 24 patients with poor prognosis, 2 patients with good prognosis). The sensitivity, specificity and integrated forecasting accuracy rates were 92.3%, 85.7% and 90.0%. 6 To compare different testing methods with GCS of the accuracy in early prediction of prognosis in patients with severe brain impairment To compare GCS with different testing methods,all the data analyzed statistically were significant difference(P<0.05), wich indicated the value of L-EEG,BAEP and L-EEG combined BAEP were higher than GCS on the accuracy of early prediction of prognosis in patients with severe brain impairment,in which the L-EEG combined with BAEP belongs to highest level of Accuracy. To compare L-EEG united BAEP with L-EEG or BAEP, all the data analyzed statistically were significant difference(P<0.05), wich indicated the value of L-EEG united BAEP were higher than L-EEG or BAEP alone on the accuracy of early prediction of prognosis in patients with severe brain impairmen.7 L-EEG and BAEP examination grading and clinical prognosis. If both of the clinical grade wereⅠ,the prognosis were better; L-EEG and BAEPⅡor grade levelⅢ, the changes in clinical outcomes with the disease for better or worse; L-EEGⅣor grade levelⅤo r at the same time BAEP gradeⅣwas in serious condition, the clinical prognosis was extremely poor .Conclusion:1 The examination grading of L-EEG or BAEP can be used as objective indicators to assess early the prognosis of patients with severe brain dysfunction, the higher the level are the worse the prognosis of patients.2 Acccording to the examination grading of L-EEG or BAEP,the sensitivity,specificity and integrated forecasting accuracy rates are higher than that of using GCS in assessment clinical outcomes on patients with severe brain impairment.3 It is very important to use L-EEG united BAEP To assess the early prognosis in patients with severe brain impairment .