Relevance of continuous EEG versus routine EEG for outcome prediction after traumatic brain injury.

ABSTRACT

INTRODUCTION: In a cohort of adult patients with disturbance of consciousness after TBI, we aimed to explore the relationship of continuous video-EEG (cEEG) and routine EEG (rEEG) with mortality and functional outcome. METHODS: Post-hoc analysis of data from a randomized controlled trial (CERTA study), in which adults with disorder of consciousness and needing EEG were randomized 11 to cEEG or two rEEG. In TBI patients, correlation between EEG duration and mortality and modified Rankin score (mRs, good 0-2) at 6 months was assessed. RESULTS: Among 364 patients, 44 patients presenting with consciousness impairment after TBI were included; 29 randomized to cEEG and 15 to rEEG. Mortality (p=0.88) and functional outcome (p=0.58) at 6 months were similar between groups. There was a nonsignificant tendency toward more seizure/status epilepticus detection with cEEG (p=0.08). In multivariable regression, cEEG was not related to functional outcome (OR 0.75 [0.13-4.24], p=0.745) or mortality (OR 7.11 [0.51-99.32], p=0.145). CONCLUSION: Despite allowing increased seizure detections in TBI patients, cEEG does not seem to be not associated with better functional clinical outcome or mortality over rEEG. Pending larger trials, repeated rEEG might be acceptable in post TBI disorder of consciousness, especially in resource-limited environments.