OBJECTIVE This study aimed to explore the effectiveness of quantitative electroencephalogram (EEG) and EEG reactivity (EEG-R) to predict the prognosis of patients with severe traumatic brain injury. METHODS This was a prospective observational study on severe traumatic brain injury. Quantitative EEG monitoring was performed for 8 to 12 hours within 14 days of onset. The EEG-R was tested during the monitoring period. We then followed patients for 3 months to determine their level of consciousness. The Glasgow Outcome Scale (GOS) score was used. The score 3, 4, 5 of GOS were defined good prognosis, and score 1 and 2 as poor prognosis. Univariate and multivariate analyses were employed to assess the association of predictors with poor prognosis. RESULTS A total of 56 patients were included in the study. Thirty-two patients (57.1%) awoke (good prognosis) in 3 months after the onset. Twenty-four patients (42.9%) did not awake (poor prognosis), including 11 cases deaths. Univariate analysis showed that Glasgow coma scale (GCS) score, the amplitude-integrated EEG (aEEG), the relative band power (RBP), the relative alpha variability (RAV), the spectral entropy (SE), and EEG-R reached significant difference between the poor-prognosis and good-prognosis groups. However, age, gender, and pupillary light reflex did not correlate significantly with poor prognosis. Furthermore, multivariate logistic regression analysis showed that only RAV and EEG-R were significant independent predictors of poor prognosis, and the prognostic model containing these 2 variables yielded a predictive performance with an area under the curve of 0.882. CONCLUSIONS Quantitative EEG and EEG-R may be used to assess the prognosis of patients with severe traumatic brain injury early. RAV and EEG-R were the good predictive indicators of poor prognosis.

中文翻译：

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定量脑电图和脑电图反应在创伤性脑损伤中的作用

目的探讨定量脑电图（EEG）和脑电图反应性（EEG-R）对严重颅脑损伤患者预后的预测价值。方法 这是一项针对严重创伤性脑损伤的前瞻性观察性研究。在发病后 14 天内进行了 8 至 12 小时的定量 EEG 监测。EEG-R 在监测期间进行了测试。然后我们跟踪患者 3 个月以确定他们的意识水平。使用格拉斯哥结果量表（GOS）评分。GOS评分3、4、5分为预后良好，1、2分为预后不良。采用单变量和多变量分析来评估预测因子与预后不良的关联。结果共有56名患者被纳入研究。32 名患者 (57. 1%）在发病后 3 个月内苏醒（预后良好）。24例（42.9%）患者未清醒（预后不良），其中11例死亡。单因素分析显示，格拉斯哥昏迷量表（GCS）评分、振幅综合脑电图（aEEG）、相对频带功率（RBP）、相对α变异性（RAV）、光谱熵（SE）和脑电图-R均达到显着水平预后不良组和预后良好组之间的差异。然而，年龄、性别和瞳孔对光反射与预后不良没有显着相关性。此外，多变量逻辑回归分析表明，只有 RAV 和 EEG-R 是预后不良的显着独立预测因子，包含这两个变量的预后模型产生的预测性能曲线下面积为 0.882。结论定量EEG和EEG-R可用于早期评估严重颅脑损伤患者的预后。RAV和EEG-R是预后不良的良好预测指标。