Increased prognostic accuracy of TBI when a brain electrical activity biomarker is added to loss of consciousness (LOC).
Background: Extremely high accuracy for predicting CT+ traumatic brain injury (TBI) using a quantitative EEG (QEEG) based multivariate classification algorithm was demonstrated in an independent validation trial, in Emergency Department (ED) patients, using an easy to use handheld device. This study...
| Publicado en: | American Journal of Emergency Medicine Vol. 35; no. 7; pp. 949 - 953 |
|---|---|
| Autores principales: | , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Elsevier B.V.
Jul2017
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=123757936&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 123757936 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07356757 1X2 jtl: American Journal of Emergency Medicine issn: 07356757 maglogo: N pubinfo: dt: Jul2017 vid: 35 iid: 7 pid: 82545 pub: Elsevier B.V. place: Philadelphia, Pennsylvania artinfo: ui: 123757936 123757936 NLM28258840 123757936 10.1016/j.ajem.2017.01.060 NLM28258840 123757936 ppf: 949 ppct: 4 formats: tig: atl: Increased prognostic accuracy of TBI when a brain electrical activity biomarker is added to loss of consciousness (LOC). aug: au: Hack, Dallas Huff, J. Stephen Curley, Kenneth Naunheim, Roseanne Ghosh Dastidar, Samanwoy Prichep, Leslie S. affil: Brain Health, Sevierville, TN, USA sug: subj: Electroencephalography Amnesia Diagnosis Unconsciousness Physiopathology Subarachnoid Hemorrhage Diagnosis Aged Male Aged, 80 and Over Head Injuries Complications Algorithms Human Adolescence Adult Subarachnoid Hemorrhage Physiopathology Predictive Value of Tests Tomography, X-Ray Computed Head Injuries Diagnosis Female Middle Age Prognosis Subarachnoid Hemorrhage Complications Head Injuries Physiopathology Unconsciousness Complications Reproducibility of Results Amnesia Complications Amnesia Physiopathology Retrospective Design Young Adult Validation Studies Comparative Studies Evaluation Research Multicenter Studies Aged: 65+ years Aged, 80 & over Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Background: Extremely high accuracy for predicting CT+ traumatic brain injury (TBI) using a quantitative EEG (QEEG) based multivariate classification algorithm was demonstrated in an independent validation trial, in Emergency Department (ED) patients, using an easy to use handheld device. This study compares the predictive power using that algorithm (which includes LOC and amnesia), to the predictive power of LOC alone or LOC plus traumatic amnesia.Participants: ED patients 18-85years presenting within 72h of closed head injury, with GSC 12-15, were study candidates. 680 patients with known absence or presence of LOC were enrolled (145 CT+ and 535 CT- patients).Methods: 5-10min of eyes closed EEG was acquired using the Ahead 300 handheld device, from frontal and frontotemporal regions. The same classification algorithm methodology was used for both the EEG based and the LOC based algorithms. Predictive power was evaluated using area under the ROC curve (AUC) and odds ratios.Results: The QEEG based classification algorithm demonstrated significant improvement in predictive power compared with LOC alone, both in improved AUC (83% improvement) and odds ratio (increase from 4.65 to 16.22). Adding RGA and/or PTA to LOC was not improved over LOC alone.Conclusions: Rapid triage of TBI relies on strong initial predictors. Addition of an electrophysiological based marker was shown to outperform report of LOC alone or LOC plus amnesia, in determining risk of an intracranial bleed. In addition, ease of use at point-of-care, non-invasive, and rapid result using such technology suggests significant value added to standard clinical prediction. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|