Turella, SSTurellaDankiewicz, JJDankiewiczBen-Hamouda, NNBen-HamoudaBernhard Nilsen, KKBernhard NilsenDüring, JJDüringEndisch, CCEndischEngstrøm, MMEngstrømFlügel, DDFlügelGaspard, NNGaspardGrejs, A MA MGrejsHänggi, MatthiasMatthiasHänggi0000-0001-5845-031XHaffey, SSHaffeyImbach, LLImbachJohnsen, BBJohnsenKemlink, DDKemlinkLeithner, CCLeithnerLegriel, SSLegrielLindehammar, HHLindehammarMazzon, GGMazzonNielsen, NNNielsenPeyre, AAPeyreRibalta Stanford, BBRibalta StanfordRoman-Pognuz, EERoman-PognuzRossetti, A OA ORossettiSchrag, CCSchragValeriánová, AAValeriánováWendel-Garcia, PPWendel-GarciaZubler, FrédéricFrédéricZublerCronberg, TTCronbergWesthall, EEWesthall2024-10-262024-10-262024-09https://boris-portal.unibe.ch/handle/20.500.12422/179243AIM Assess the prognostic ability of a non-highly malignant and reactive EEG to predict good outcome after cardiac arrest (CA). METHODS Prospective observational multicentre substudy of the "Targeted Hypothermia versus Targeted Normothermia after Out-of-hospital Cardiac Arrest Trial", also known as the TTM2-trial. Presence or absence of highly malignant EEG patterns and EEG reactivity to external stimuli were prospectively assessed and reported by the trial sites. Highly malignant patterns were defined as burst-suppression or suppression with or without superimposed periodic discharges. Multimodal prognostication was performed 96 hours after CA. Good outcome at 6 months was defined as a modified Rankin Scale score of 0-3. RESULTS 873 comatose patients at 59 sites had an EEG assessment during the hospital stay. Of these, 283 (32%) had good outcome. EEG was recorded at a median of 69 hours (IQR 47-91) after CA. Absence of highly malignant EEG patterns was seen in 543 patients of whom 255 (29% of the cohort) had preserved EEG reactivity. A non-highly malignant and reactive EEG had 56% (CI 50-61) sensitivity and 83% (CI 80-86) specificity to predict good outcome. Presence of EEG reactivity contributed (p<0.001) to the specificity of EEG to predict good outcome compared to only assessing background pattern without taking reactivity into account. CONCLUSION Nearly one-third of comatose patients resuscitated after CA had a non-highly malignant and reactive EEG that was associated with a good long-term outcome. Reactivity testing should be routinely performed since preserved EEG reactivity contributed to prognostic performance.enCardiac arrest Coma EEG Outcome Prognosis Reactivity600 - Technology::610 - Medicine & healtharticle10.48350/1991153902957910.1016/j.resuscitation.2024.110319