Abstract:

Objective  To evaluate the value of different coma scales and 95% spectral edge frequency(SEF) in the central area in predicting the recent death in patients with acute coma. Methods  Fifty-two patients with acute coma admitted in the neurointensive care unit in Affiliated Hospital of Nantong University from August 2014 to October 2016 were included. Glasgow coma scale (GCS), Glasgow-Pittsburgh coma scale (GCS-P), and full outline of unresponsiveness score (FOUR) were performed within 72 hours of the onset of the patients. EEG monitoring was performed and the data of 95% SEF in the central area were recorded simultaneously. The patients were divided into two groups: survival group and death group according to one-month followup. The age, sex, previous history, GCS score, GCS-P score, FOUR score and 95% SEF in the central area were compared between two groups. Single factor and multivariate logistic regression analysis were used to investigate relevant factors related to the recent death. The predictive value of GCS score, GCS-P score, FOUR score and 95% SEF in the central area were compared with the receiver operating characteristic (ROC) curve. The GCS score, the GCS-P score, and the FOUR score combined with the 95% SEF in the central area were compared with the above scores used alone by McNemarχ2 test in the sensitivity and specificity of predicting the recent death. Results   Of the 52 patients, 39 of them were in the survival group and 13 of them were in the death group. Compared with the survival group, the GCS score, GCS-P score, FOUR score and 95% SEF in the central area were significantly decreased in the death group (P<0.05, P<0.01, P<0.01, P<0.01, respectively). Multivariate logistic regression analysis showed that GCS score, GCS-P score, FOUR score and 95% SEF in the central area were independent predictors of one-month death. ROC curve analysis showed that GCS score, GCS-P score, FOUR score and 95% SEF in the central area had moderate predictive value for one-month death. There was no significant difference in sensitivities between the GCS score, the GCS-P score, the FOUR score combined with the 95% SEF in the central area vs the above scores used alone (P>0.05, P>0.05, P>0.05, respectively), but the specificities were significantly higher (P<0.05, P<0.05, P<0.05, respectively). Conclusion  GCS score, GCS-P score, FOUR score, and 95% SEF in the central area can be used to predict the recent death of patients with acute coma. Coma scales combined with 95% SEF in the central area are more effective in predicting the recent death of patients with acute coma.

Key words: Spectral edge frequency, Coma scales, Death, Central area, Coma, Electroencephalogram, Human