Predictive value of an early amplitude integrated electroencephalogram and neurologic examination

Seetha Shankaran, Athina Pappas, Scott A. McDonald, Abbot R. Laptook, Rebecca Bara, Richard A. Ehrenkranz, Jon E. Tyson, Ronald Goldberg, Edward F. Donovan, Avroy A. Fanaroff, Abhik Das, W. Kenneth Poole, Michele Walsh, Rosemary D. Higgins, Cherie Welsh, Walid Salhab, Waldemar A. Carlo, Brenda Poindexter, Barbara J. Stoll, Ronnie GuilletNeil N. Finer, David K. Stevenson, Charles R. Bauer

Research output: Contribution to journalArticlepeer-review

77 Scopus citations


OBJECTIVE: To examine the predictive validity of the amplitude integrated electroencephalogram (aEEG) and stage of encephalopathy among infants with hypoxic-ischemic encephalopathy (HIE) eligible for therapeutic whole-body hypothermia. DESIGN: Neonates were eligible for this prospective study if moderate or severe HIE occurred at <6 hours and an aEEG was obtained at <9 hours of age. The primary outcome was death or moderate/severe disability at 18 months. RESULTS: There were 108 infants (71 with moderate HIE and 37 with severe HIE) enrolled in the study. aEEG findings were categorized as normal, with continuous normal voltage (n = 12) or discontinuous normal voltage (n = 12), or abnormal, with burst suppression (n = 22), continuous low voltage (n = 26), or flat tracing (n = 36). At 18 months, 53 infants (49%) experienced death or disability. Severe HIE and an abnormal aEEG were related to the primary outcome with univariate analysis, whereas severe HIE alone was predictive of outcome with multivariate analysis. Addition of aEEG pattern to HIE stage did not add to the predictive value of the model; the area under the curve changed from 0.72 to 0.75 (P = .19). CONCLUSIONS: The aEEG background pattern did not significantly enhance the value of the stage of encephalopathy at study entry in predicting death and disability among infants with HIE.

Original languageEnglish (US)
Pages (from-to)e112-e120
Issue number1
StatePublished - Jul 2011
Externally publishedYes


  • Amplitude integrated EEG
  • Neonatal hypoxic-ischemic encephalopathy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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