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From Medline and Embase databases we selected studies concerning patients older than 10 years with anoxic-ischemic coma in which findings from early neurological examination, electroencephalogram (EEG), or somatosensory evoked potentials (SSEP were related to poor outcome - defined as death or survival in a vegetative state. In 33 studies, 14 prognostic variables were studied, three of which had a specificity of 100%; absence of pupillary light reflexes on day 3; absent motor response to pain on day 3; and bilateral absence of early cortical SSEP within the first week. SSEP has the smallest CI of its pooled positive-likelihood ratio and its pooled false-positive test rate. Because evoked potentials are also the least susceptible to metabolic changes and drugs, recording of SSEP is the most useful method to predict poor outcome. |
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