Extended Glasgow Outcome Scale correlates with bispectral index in traumatic brain injury patients who underwent craniotomy

Mahadewa, Tjokorda Gde Bagus; Senapathi, TjokordaGde Agung; Wiryana, Made; Aribawa, I Gusti Ngurah Mahaalit; Arparitna, Ketut Yudi; Ryalino, Christopher

doi:10.2147/oaem.s164221

Cited by 4 publications

(6 citation statements)

References 11 publications

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“…Our results are consistent with previous studies, which revealed that for patients with severe brain injury, the BIS value of patients who had a return of consciousness was significantly higher than that of those who did not (Mahmood et al, 2017), suggesting that BIS value had predictive prognosis value (Li et al, 2019). In addition, consistent with our study, Li et al (2019) found that BIS value was highly associated with GCS score, especially with a GCS score of less than 9, indicating that BIS was more sensitive in patients with severe brain injury (Mahadewa et al, 2018). In this study, the BIS value was applied to predict the prognosis of patients with severe brain injury.…”

Section: Discussionsupporting

confidence: 90%

Evaluation of Prognosis of Coma Patients With Acute Brain Injury by Electroencephalogram Bispectral Index Monitoring

Shi

Shen

et al. 2021

Journal of Trauma Nursing

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Background: The high mortality rate of comatose patients with traumatic brain injury is a prominent public health issue that negatively impacts patients and their families. Objective, reliable tools are needed to guide treatment decisions and prioritize resources. Objective: This study aimed to evaluate the prognostic value of the bispectral index (BIS) in comatose patients with severe brain injury. Methods: This was a retrospective cohort study of 84 patients with severe brain injury and Glasgow Coma Scale (GCS) scores of 8 and less treated from January 2015 to June 2017. Sedatives were withheld at least 24 hr before BIS scoring. The BIS value, GCS scores, and Full Outline of UnResponsiveness (FOUR) were monitored hourly for 48 hr. Based on the Glasgow Outcome Scale (GOS) score, the patients were divided into poor (GOS score: 1–2) and good prognosis groups (GOS score: 3–5). The correlation between BIS and prognosis was analyzed by logistic regression, and the receiver operating characteristic curves were plotted. Results: The mean (SD) of the BIS value: 54.63 (11.76), p = .000; and GCS score: 5.76 (1.87), p = .000, were higher in the good prognosis group than in the poor prognosis group. Lower BIS values and GCS scores were correlated with poorer prognosis. Based on the area under the curve of receiver operating characteristic curves, the optimal diagnostic cutoff value of the BIS was 43.6, and the associated sensitivity and specificity were 85.4% and 74.4%, respectively. Conclusion: Taken together, our study indicates that BIS had good predictive value on prognosis. These findings suggested that BIS could be used to evaluate the severity and prognosis of severe brain injury.

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Section: Discussionsupporting

confidence: 90%

Evaluation of Prognosis of Coma Patients With Acute Brain Injury by Electroencephalogram Bispectral Index Monitoring

Shi

Shen

et al. 2021

Journal of Trauma Nursing

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“…12,28 And finally, a lot of researchers have investigated the predictive performances of BIS scoring for neurological outcome or mortality in different clinical conditions such as after brain injury and other comatose patients in the last decades. 10,15–17,21,29,30 Dou et al 10 found that BIS values >42.5 were correlated with the prognosis of comatose patients in ICU. Fabregas et al 16 studied a model relating BIS to the probability of recovery of consciousness in patients with severe brain injury.…”

Section: Discussionmentioning

confidence: 99%

“…After that, the association between BIS index and the depth of coma had been studied in head injured or other comatose patients 12 , 28 . And finally, a lot of researchers have investigated the predictive performances of BIS scoring for neurological outcome or mortality in different clinical conditions such as after brain injury and other comatose patients in the last decades 10 , 15–17 , 21 , 29 , 30 . Dou et al 10 found that BIS values >42.5 were correlated with the prognosis of comatose patients in ICU.…”

Section: Discussionmentioning

confidence: 99%

Bispectral Index in predicting in‐hospital mortality in patients with ischemic stroke: A methodological study

Gür

Akbaş

Kose

et al. 2022

Hong Kong j. emerg. med.

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Background: Ischemic stroke is a leading cause of death and functional disability worldwide. Several clinical scores or stroke scales, biological test or markers, clinical signs, and radiological imaging have been performed to predict both worse neurologic outcome and mortality for ischemic stroke. Objectives: The aim of our study was to investigate the association between early Bispectral Index scores and in-hospital mortality in patients with ischemic stroke. Methods: This is a comparative prospective methodological study, in which we evaluated the predictive accuracies of Bispectral Index, Glasgow Coma Scale, and Charlson Comorbidity Index for in-hospital mortality of patients with ischemic stroke. Receiver operating characteristic analysis was used for comparing the accuracy of the scoring systems, areas under receiver operating characteristic curves were calculated, and Youden J index was used for estimating associated cut-off values. Results: Among the 80 ischemic stroke patients, in-hospital mortality rate was 38.8% (n = 31). The areas under receiver operating characteristic curves were 0.984, 0.960, and 0.863 for Bispectral Index, Glasgow Coma Scale, and Charlson Comorbidity Index, respectively. The difference between areas under receiver operating characteristic curves for Bispectral Index and Glasgow Coma Scale was statistically similar. Besides, the difference between areas under receiver operating characteristic curves for Bispectral Index and Charlson Comorbidity Index, and the difference between areas under receiver operating characteristic curves for Glasgow Coma Scale and Charlson Comorbidity Index were statistically significant. The associated cut-off values were ⩽74, ⩽12, and >4 for Bispectral Index, Glasgow Coma Scale, and Charlson Comorbidity Index, respectively. For these cut-off points, sensitivity and specificity of Bispectral Index were 93.6% and 95.9%, sensitivity and specificity of Glasgow Coma Scale were 100.0% and 83.7%, and sensitivity and specificity of Charlson Comorbidity Index were 83.9% and 69.4%, respectively. However, accuracy of Bispectral Index was 95.0%, accuracy of Glasgow Coma Scale was 90.0%, and accuracy of Charlson Comorbidity Index was 75.0. Conclusion: Knowledge of the risk factors for mortality in patients with ischemic stroke can help to identify which patients have a higher risk of fatal outcome. The Bispectral Index score improved discrimination and classified patients with higher mortality better than both Glasgow Coma Scale and Charlson Comorbidity Index.

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“…Findings suggest that BIS scores upon admission may be used to predict the outcomes in patients with TBI. An equation to predict GOS-E from BIS value derived from the linear regression analysis in this study, and this is GOS-E =0.19(BIS) -8.3 [70].…”

Section: Eeg-based Markers To Classify Tbi Severitymentioning

confidence: 99%

“…Further an equation to predict GCS from a BIS value derived using linear regression analysis: GCS = 0.21(BIS) -5.208. Mahadewa assessed the correlation between Glasgow Outcome Scale-Extended (GOS-E) scores calculated 6 months after the TBI event with BIS values on admission in 68 TBI patients who underwent craniotomy, correlation was at r =0.921, p<0.01 (70). Findings suggest that BIS scores upon admission may be used to predict the outcomes in patients with TBI.…”

Section: Eeg-based Markers To Classify Tbi Severitymentioning

confidence: 99%

Electroencephalography (EEG)-based detection, management, recovery and brain retraining tracking of Traumatic Brain Injury (TBI) when “Only Time Can Tell”

Miranda¹,

Cd²,

Alexander³

et al. 2020

J Syst Integr Neurosci

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Traumatic brain injury (TBI) can be caused by accidents like road traffic accidents (RTA), sports injuries, and injuries at home. It is a major health issue, very often fatal and causing high morbidity, changing the lives of both the person injured and the families involved. Anticipating and preventing secondary injury and seizures post-trauma, defining severity of TBI, predicting TBI outcomes and arousal from coma or declaration of vegetative state or brain death form pivotal checkpoints in TBI management. Other challenges faced include identifying malingerers from genuine individuals with post-TBI morbidity, defining the severity of previous TBI in the field or previous injuries when reports are lost. Depending on both its severity and location it can cause a variety of post-TBI cognitive, sensory and tactile, and motor impairments. In such instances the present paper looks at how the electroencephalographs (EEG) like NeuralScan can and do contribute uniquely and significantly aiding in assessment, continuous/periodic evaluation during the course of recovery, brain-retraining and rehabilitation in evaluating temporal changes in neuronal functionality following TBI.

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Extended Glasgow Outcome Scale correlates with bispectral index in traumatic brain injury patients who underwent craniotomy

Cited by 4 publications

References 11 publications

Evaluation of Prognosis of Coma Patients With Acute Brain Injury by Electroencephalogram Bispectral Index Monitoring

Evaluation of Prognosis of Coma Patients With Acute Brain Injury by Electroencephalogram Bispectral Index Monitoring

Bispectral Index in predicting in‐hospital mortality in patients with ischemic stroke: A methodological study

Electroencephalography (EEG)-based detection, management, recovery and brain retraining tracking of Traumatic Brain Injury (TBI) when “Only Time Can Tell”

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