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Within the first year after cardiac arrest,20%of patients made a good neurologic recovery;80%remained in a vegetative state or died.Clinical examination correctly predicted outcome in 58%of patients,SEP in 59%,and EEG in 41%.The combination of clinical examination,SEP,and EEG raised the percentage of correct predictions to 82%,without false pessimistic predictions.Concentrations of serum neuron specific enolase and ionised calcium were of no additional prognostic help.Multivariate regression analysis identified the association of CGS<8 at 48 hours with abnormal or absent early cortical SEPs at highly predictive of a bad outcome(risk=97%, 95%confidence interval=86-99%).The combination of GCS at 48 hours,SEP,and if these are nonconclusive,EEG,permits more reliable prediction of outcome in postanoxic coma than clinical examination alone. |
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