The Prognostic Value Of Amplitude Integrated EEG Combined With P50 In Patients With Severe Cerebrovascular Diseases

Background and Object:Stroke is one of the leading causes of disability and death in adults.The main purpose of this study was to explore the predictive value of amplitude integrated EEG(a EEG),Young gradings,sensory gating P50 in patients with severe cerebrovascular diseases.And compare the performances of a EEG,EEG Young gradings and sensory gating P50 with the Glasgow Coma Scale(GCS).At the same time,we want to explore whether a EEG,EEG Young gradings and sensory gating P50 can be used as a new method to predict the prognosis of patients with severe cerebrovascular diseases.Patients and Method:Part I(a EEG):Thirty-seven patients presenting with severe cerebrovascular diseases admitted to the neurological intensive care unit(NCU)were included within the first 72 hour of clinical evolution.General data,Glasgow coma scale(GCS),EEG Young grading and a EEG model were collected.Follow-ups were done after 3 months and the patients’ outcomes were assessed by the Glasgow outcome Scale(GOS).Representative original EEG fragments were selected for amplitude integration compression to obtain amplitude integration EEG(a EEG).We conducted correlation analysis among amplitude integration EEG grading and conventional EEG grading and GCS of cerebral function of patients’ prognosis.The predictive ability of a EEG and EEG Young grading for brain function prognosis was evaluated by logistic regression model.Part II(sensory gating P50):For patients with severe cerebrovascular disease admitted to the intensive care unit of neurology department,sensory gating P50 was conducted within 72 h after the onset of disease.Each patient was monitored at least once,and a total of 37 person-times of sensory gating P50 were recorded.General data,Glasgow coma scale(GCS)were collected.Follow-ups were done after 3 months and the patients’ outcomes were assessed by the Glasgow outcome Scale(GOS).Patients were grouped by prognosis,and we compared the relationships among sensory gating P50 ratio(S2/S1),GCS score and prognosis.And 10 age-matched normal controls(NC)were recruited(they were our hospital staff or patients’ family members).And the ratio of sensory gating P50 between the experimental group and the control group was compared.Results:1.It shown that EEG Young grading was positively correlated with the prognosis at 3 months.And GCS scores negatively correlated with the 3-month prognosis.2.There was a significant difference between patients who died and patients who survived in a EEG and EEG Young grading.In Logistic regression analysis,death was predicted by a EEG and EEG Young grading with overall accuracy of 88.6% and 88.6%,more accurate than GCS scores(80%).3.We found that there were no difference between patients who died and patients who survived except in the application of ventilators.4.There was no significant difference between patients in the sensory gating P50 ratio between the good prognosis group and the poor prognosis group.5.There was no significant difference in the ratio of sensory gating P50 between the experimental group and the control group.Conclusions:1.Amplitude integrated EEG may be a new method to pridictive the value of severe cerebrovascular diseases.2.Young grade of electroencephalogram has certain significance in predicting the prognosis of patients with severe cerebrovascular disease.3.The combination of a EEG and Young grades can improve the accuracy of prognosis judgment.4.The value of sensory gating P50 in the 3-month prognosis of severe cerebrovascular disease still needs to be further explored.