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Postanoxic alpha, theta or alpha-theta coma: Clinical setting and neurological outcome

Abstract: Aim The aim of this study was to determine the prognosis of 26 consecutive adults with alpha coma (AC), theta coma (TC) or alpha-theta coma (ATC) following CRA and to describe the clinical setting and EEG features of these patients. Methods We retrospective analyzed a prospectively collected cohort of adult patients diagnosed as having AC, TC or ATC after CRA between January 2008 and June 2016. None of patients included in this analysis underwent therapeutic hypothermia (TH). Neurological outcome was expressed as the best score 6 months after CRA using the five-point Glasgow-Pisttsburgh Cerebral Performance Categories (CPC) Results Twenty-six patients were identified with a diagnosis of postanoxic AC, TC or ATC coma. There were 20 (77%) men and 6 (23%) women. The mean age was 63?±?16?years. The most frequent EEG pattern was TC (21 patients, 80%), followed by AC (3 patients, 12%) and ATC (2 patients, 8%). The cardiac rhythm as primary origin of the CRA was ventricular fibrillation (VF) in 16 patients (61.5%), asystole in 8 patients (34.6%) and ventricular tachycardia (VT) in one patient (3.8%). The presence of EEG reactivity was present in 8 patients (30%). The mortality rate was 85%. Of the 4 surviving patients, two (3.8%) had moderate disability (CPC 2), one (3.8%) had severe disability (CPC 3) and one (3.8%) reached a good recovery. The age was significantly lower in survivors 46.2?±?10.8 versus nonsurvivors 63.3?±?15.5 (p?=?0.04). There was increased association of EEG reactivity with survival (p?=?0.07). Conclusion Hypoxic-ischemic AC, TC and ATC are associated with a poor prognosis and a high rate of mortality. In younger patients with AC, TC and ATC and incomplete forms showing reactivity on the EEG, there is a greater probability of clinical recovery.

 Fuente: Resuscitation Volume 124, March 2018, Pages 118-125

 Editorial: Elsevier

 Fecha de publicación: 01/03/2018

 Nº de páginas: 7

 Tipo de publicación: Artículo de Revista

 DOI: 10.1016/j.resuscitation.2017.12.022

 ISSN: 0300-9572,1873-1570

 Url de la publicación: https://doi.org/10.1016/j.resuscitation.2017.12.022

Autoría

LÓPEZ DELGADO, ANJANA

MIGUEL ANGEL HERNANDEZ HERNANDEZ

PARAMIO PAZ, ALICIA

PÍA MARTÍNEZ, CARLA

ORIZAOLA, PEDRO

MARTÍN GARCÍA, MARÍA