The EEG as an independent indicator of mortality and healthcare utilization
ABSTRACT Determine whether EEG findings could be used as an independent prognostic indicator of outcomes in a general patient population.
A large electronic medical record was used to merge the results of EEG studies with the results of medical evaluations including: medications prescribed, medical diagnoses, blood test results, imaging results, and outcomes in 3193 patients. Univariable and multivariable analyses were undertaken to determine whether the EEG had a role in predicting outcomes independent of other factors in a clinic population.
Patients with abnormal EEG's had significantly higher mortalities, greater cost of healthcare and more evaluation visits than patients with normal EEG's in every age range independent of the presence other medical conditions. The costs associated with caring for a patient with an abnormal EEG were roughly three times that of a patient with a normal EEG. The risk of death in the multivariable analysis was 3.7 times higher in patients with an abnormal EEG than in patients with a normal EEG.
In addition to its traditional diagnostic implications, the EEG may convey information about general level of illness and the cost of caring for patients.
Certain EEG findings may identify high risk patients and thus may open the door to possible interventions.
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ABSTRACT: Stroke is a major cause of adult-onset disability and dependency. We investigated whether EEG parameters are of prognostic value for functional outcome 6 months after ischemic stroke. One-hundred and ten patients presenting with acute ischemic stroke and persistent neurological deficits at EEG recording were incrementally included. Clinical characteristics, volume of ischemia and EEG parameters were correlated with functional outcome assessed with the modified Rankin Scale (mRS) score. Predictive values for disability, dependency and death were calculated using receiver operating characteristic (ROC) curves and logistic regression modeling. The EEG pairwise derived Brain Symmetry Index (pdBSI) and (delta+theta)/(alpha+beta) ratio (DTABR) were significantly correlated with the modified Rankin Scale (mRS) score at month 6 (Spearman ρ=0.46 and ρ=0.47, respectively, p<0.0005 for both). NIHSS (OR 1.15, 95% CI 1.04-1.27, p=0.005) and pdBSI (OR 4.07, 95% CI 1.32-12.58, p=0.015) were independently associated with disability 6 months after stroke. Dependency was independently indicated by NIHSS (OR 1.22, 95% CI 1.09-1.37, p<0.0005) and DTABR (OR 2.25, 95% CI 1.16-4.37, p=0.016). Six month mortality was independently indicated by age at stroke onset (OR 1.18, 95% CI 1.05-1.32, p=0.007), NIHSS (OR 1.11, 95% CI 1.03-1.21, p=0.009) and DTABR (OR 2.04, 95% CI 1.08-3.85, p=0.028). EEG in the subacute setting of ischemic stroke may be of prognostic value for disability, dependency and death after 6 months. Early prognostication of functional outcome after stroke is relevant to efficient rehabilitation management to enhance recovery and minimize long-term disability.Clinical neurophysiology: official journal of the International Federation of Clinical Neurophysiology 10/2010; 122(5):874-83. DOI:10.1016/j.clinph.2010.07.028 · 2.98 Impact Factor