Is clinical assessment alone as good as electrophysiological testing in predicting outcomes?
When a patient is comatose after cardiopulmonary resuscitation (CPR), the neurologist is often called upon to do the impossible: to predict with perfect accuracy the likelihood of awakening and (if the patient survives) future morbidity. For many years, a neurological examination has remained the gold standard for such determination. But whether additional electrophysiological tests may better predict clinical outcomes has long been of interest, and multiple studies of their usefulness have been published (e.g., JW Neurol Oct 17 2006).
Now, researchers have performed a meta-analysis of 25 studies with detailed information on predictive tests and outcomes of hypoxic coma gathered from the international literature. They compared the prognostic…