A novel scoring system to predict the outcomes of adult patients with hypoxic-ischemic encephalopathy

ABSTRACT

Background: Adult patients with hypoxic-ischemic encephalopathy (HIE) often incur large costs, but their outcomes are poor. Currently, there is lack of a comprehensive quantitative approach to predict patient prognoses.

Methods: A total of 73 adult patients with HIE participated in this prospective, observational study. Clinical assessments, laboratory tests, and electrophysiological examinations were conducted within 3 days after HIE occurred. Logistic regression model was used to identify independent factors associated with patient outcomes.

Results: After a 6-month follow-up, 44 (61.1%) patients survived, 28 (38.9%) patients died, and one patient was lost to follow-up. The level of blood calcium and lactate, the presence of electroencephalography reactivity, and Glasgow Coma Scale (GCS) score were significantly associated with the patient’s outcome. Based on the regression coefficients from logistic regression analysis, we constructed a scoring system (CEGL; C: calcium, E: EEG reactivity, G: GCS, L: lactate) to predict the possibility of a patient’s death. The area under the receiver operating characteristic curve was 0.91 (P < 0.001, 95% CI [0.87–0.95]) with a specificity of 97.7% and a positive predictive value of 97.4%.

Conclusion: CEGL score can provide clinicians useful information for assessment of patient prognosis within 6 months after HIE.

KEYWORDS:

• Hypoxic-ischemic encephalopathy
• adult
• prognosis prediction
• scoring system
• EEG
• clinical assessment

Acknowledgments

We thank all of the patients in this study for their cooperation. We also thank American Journal Experts (http://www.journalexperts.com/) for their English language editing and proofreading.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

HYD, LF, and WXF designed this study, executed the trial procedures, followed up the patients, centralized the database, and analyzed the data. HYD, LF, LGW, and QFY reviewed the literature and collected the data. LBS, HYD, TX, and FGB performed the statistical analysis. HYD wrote the manuscript. HYD, TX, FGB, and LF revised this manuscript.

Supplemental data

Supplemental data for this article can be accessed here.

Additional information

Funding

This paper was supported by the National Natural Science Foundation of China (Grant no: 81301109) and the Chongqing Health and Family Planning Commission (Grant no: 2016MSMXM011).