• Wenli Miao.
• Intensive Care Unit, Hospital No. 401 of the Chinese People's Liberation Army, Minjiang Road 22, Qingdao, 266071, Shandong, China, wenlimiao1212@hotmail.com.
• J Anesth. 2013 Dec 1;27(6):855-61.

PurposeWe assessed the ability of bispectral index (BIS) to predict clinical outcome (dead or alive within 2 weeks).MethodsIn total, 90 coma patients with severe brain injuries underwent BIS monitoring, and serum neuron-specific enolase (NSE) and S100 protein levels were assayed within the first 3 days of admission. Receiver operator characteristic (ROC) curve analysis was used to assess the performance of BIS values for predicting death within 2 weeks. A cutoff value was calculated using the Youden index.ResultsA significant negative correlation was found between BIS value and serum NSE and S100 levels. The area under the curve for BIS value was 0.841 (p < 0.001, 95 % CI = 0.751-0.931), and higher than for NSE (0.713) (p = 0.002, 95 % CI = 0.582-0.844) or S100 (0.790) (p < 0.001, 95 % CI = 0.680-0.899). The optimal cutoff of BIS was 32.5. Serum NSE and S100 protein levels and the mortality rate were significantly lower in patients with a BIS value >32.5 than in patients with a BIS value ≤32.5.ConclusionsBispectral index values may reflect degree of brain injury, and BIS is an objective and noninvasive monitoring method for helping clinicians to predict death in patients with a BIS value ≤32.5.

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