The predicted value of EEG reactivity with impaired consciousness patients: A Systematic Review and Meta-Analysis

Abstract Background Identifying the prognosis of coma patients remains challenging. Electroencephalograph (EEG) has emerged as a diagnostic tool of choice to detect the good or bad outcomes of coma patients. This systematic review and meta-analysis aimed to evaluate the prognostic value for the prediction of good outcomes after coma and compared it to the prognostic value of the Glasgow Coma Scale (GCS) score. Methods The PubMed, Embase, Web of Science, and Ovid databases were searched in April 2022. The strategy complied with the PRISMA guidelines. Results 12 clinical studies were included in the meta-analysis. In the overall analyses, the areas under the summary receiver operating characteristic curves were 0.86 for EEG-R and 0.77 for GCS score, respectively. EEG reactivity (EEG-R) had a sensitivity of 76% and a specificity of 82%. The GCS score showed poor diagnostic accuracy, with a specificity of 69% and a sensitivity of 73%. In subgroup analyses, we found no difference in diagnostic accuracy between prognostic assessment criteria, or type of illness. Conclusions This analysis demonstrated that patients with impaired consciousness featuring a reactive EEG are more likely to have favorable outcomes.