Clinical and electroencephalographic findings in patients with sepsis-associated encephalopathy and the evaluation of their effects on survival

Abstract

Objective: Acute brain dysfunction is common in sepsis patients and is associated with increased mortality. This study aimed to investigate the clinical and electroencephalographic (EEG) findings of patients with acute neurological dysfunction due to sepsis and to evaluate their relationship with prognosis.Methods: Sixty-one patients with sepsis were included in this prospective observational study. All patients underwent a daily neurological examination. EEG monitoring was performed in patients with delirium, coma, clinical seizures, and focal neurological findings. The patients were divided into two groups as survivors and non-survivors.Results: Sixty-one patients included in the study had a median age of 60 years (range=21 to 81), Acute Physiology and Chronic Health Evaluation 2 score of 24 (range=14 to 39), and Sepsis-related Organ Failure Assessment score of 10 (range=3 to 24). During the EEG examination, coma was detected in 23 patients (38%), delirium/confusion in 20 patients (33%), clinical seizures in 16 patients (26%) and focal neurological findings in two patients (3%). The overall mortality rate was 42% (n=26). The EEG examination showed slowing of background activity in all patients. Also, among three patients who had seizure activity, two showed findings of an electrophysiological seizure. The EEG examination revealed a relationship between low-amplitude non-reactive background activity and mortality.Conclusion: EEG monitoring may be indicated in the follow-up of encephalopathy in sepsis, the determination of the severity of the disease, the presence of an accompanying seizure or status, and prognosis.Keywords: Sepsis, brain dysfunction, electroencephalography, prognosis