EEG changes in critically ill patients with sepsis associated encephalopathy and its correlation with morbidity and mortality

Abstract

Background Sepsis-associated encephalopathy (SAE) refers to multifactorial syndrome manifested by generalized cerebral dysfunction induced by systemic response to infections with no clinical or laboratory evidence of directly cerebral infections or other forms of encephalopathy. The electroencephalogram (EEG) is one of the methods that allow physicians to continuously monitor the cerebrum and help management decisions. We studied the EEG changes in predicting morbidity and mortality of SAE in critically ill cases suffering sepsis or septic shock.Patients and Methods In this prospective observational study, 80 cases with sepsis or septic shock were subjected to EEG recording to assess EEG changes in critically ill patients with SAE and its correlation with their morbidity and mortality.Results There was a statistically significant difference in prognostic performance for EEG grading between survivors and non survivors to predict mortality. The area under the curve (AUC) was 0.887, cut off was > 2#, sensitivity was 87.50 and specificity was 81.25 and accuracy was 83.75 as the higher the score was associated with higher mortality. There was statistically significant association between EEG grading and 28-day mortality (p-value ˂0.001). Also, there was statistically significant association between EEG grading and the need for mechanical ventilation and vasopressors (p-value ˂0.001). There was a significant association between EEG within 72 hours of admission and length of ICU stay (p-value ˂ 0.017).Conclusion Early EEG changes have a positive correlation with morbidity and mortality and can be used as a good predictor in cases suffering sepsis or septic shock presenting with SAE.

Keywords

• Electroencephalogram
• sepsis-associated encephalopathy
• septic shock
• sepsis