Value of amplitude-integrated EEG combined with Full Outline of Unresponsiveness in evaluating the prognosis of children with disturbance of consciousness

Abstract:

Objective To study the value of amplitude-integrated EEG (aEEG), Full Outline of Unresponsiveness (FOUR), and Glasgow Coma Scale (GCS) in evaluating the prognosis of children with disturbance of consciousness in the pediatric intensive care unit (PICU). Methods A total of 164 children with disturbance of consciousness who were admitted to the PICU of Children's Hospital Affiliated to Soochow University were enrolled as subjects. According to prognosis, they were divided into a poor prognosis group with 111 children and a good prognosis group with 53 children. The results of aEEG monitoring, FOUR score, and GCS score on days 1 and 5 of admission were collected. The association between evaluation methods and prognosis was analyzed. The receiver operating characteristic (ROC) curve was used to evaluate the value of aEEG, FOUR, and GCS in predicting prognosis. Results The children with no improvement or abnormal aggravation of aEEG on day 5 tended to have a poor prognosis. The results of aEEG was positively correlated with prognosis (r=0.689, P < 0.001), and FOUR and GCS were negatively correlated with prognosis (r=-0.655 and -0.554 respectively, P < 0.001). The areas under the ROC curve (AUC) of aEEG, FOUR, and GCS were 0.894, 0.903, and 0.840 respectively, and there was no significant difference in the AUC between the three indices (P > 0.05), while aEEG combined with FOUR had an AUC of 0.945, which was significantly larger than that of each index alone (P < 0.05). Conclusions Both aEEG and FOUR can be used as effective tools to predict the prognosis of children with disturbance of consciousness, and a combination of aEEG and FOUR can improve the predictive value.