AUTHOR=Arciniegas-Villanueva Andrea Victoria , Fernández-Diaz Eva María , Gonzalez-Garcìa Emilio , Sancho-Pelluz Javier , Mansilla-Lozano David , Segura Tomás TITLE=Functional and Prognostic Assessment in Comatose Patients: A Study Using Somatosensory Evoked Potentials JOURNAL=Frontiers in Human Neuroscience VOLUME=16 YEAR=2022 URL=https://www.frontiersin.org/journals/human-neuroscience/articles/10.3389/fnhum.2022.904455 DOI=10.3389/fnhum.2022.904455 ISSN=1662-5161 ABSTRACT=Aim

The functional prognosis of patients after coma following either cardiac arrest (CA) or acute structural brain injury (ABI) is often uncertain. These patients are associated with high mortality and disability. N20 and N70 somatosensory evoked potentials (SSEP) are used to predict prognosis. We evaluated the utility of SSEP (N20–N70) as an early indicator of long-term prognosis in these patients.

Methods

This was a retrospective cohort study of patients (n = 120) admitted to the intensive care unit (ICU) with a diagnosis of coma after CA (n = 60) or ABI (n = 60). An SSEP study was performed, including N20 and N70 at 24–72 h, after coma onset. Functional recovery was assessed 6–12 months later using the modified Glasgow scale (mGS). The study was approved by our local research ethics committee.

Results

In the CA and ABI groups, the absence of N20 (36% of CA patients and 41% of ABI patients; specificity = 100%) or N70 (68% of CA patients and 78% of ABI patients) was a strong indicator of poor outcome. Conversely, the presence of N70 was an indicator of a good outcome (AC: specificity = 84.2%, sensitivity = 92.7%; ABI: specificity = 64.2% sensitivity = 91.3%).

Conclusion

Somatosensory evoked potentials are useful early prognostic markers with high specificity (N20) and sensitivity (N70). Moreover, N70 has additional potential value for improving the prediction of good long-term functional outcomes.

Clinical Trial Registration:

[https://clinicaltrials.gov/], identifier [2018/01/001].