Abstract
Objective To explore the value of new brainstem auditory evoked potential grading in prediction of awakening in unconscious patients after traumatic brain injury ( TBI ).Method BAEPs were recorded and analyzed in 93 patients suffering from TBI with duration of disturbance of unconsciousness.BEAPs were classified into three grades:Gradel-all BEAP findings were normal;Grade Ⅲ -bilateral PL of wave Vor IPL of wave Ⅲ ~ Ⅴ were abnormal,unilateral or bilateral wave Ⅴ were absent;Grade Ⅱ- any abnormal BAEPs except Grade Ⅲ,including unilateral or bilateral peak latency(PL) of waveⅠ,Ⅲ,inter peak latency(IPL) of wave Ⅰ ~ Ⅲ or amplitude ratio of waveⅠand Ⅴ were abnormal,or unilateral PL of wave Ⅴ or IPL of wave Ⅲ ~ Ⅴwere abnormal.Conscious or unconscious at the 6th month after injury was considered as the outcome criterion.Results The new grading standards showed grade Ⅰ,Ⅱ and Ⅲ have 79%,18% and 0% of patients awaking at the 6th month.The new BAEP grading standards had significant correlation with the probabilities of awakening( r =-0.662,P <0.001 ; The higher the grades,the lower the probability of awakening).The area under the ROC curve was 0.859 and 95% confidence interval was (0.781 ~ 0.937 ) of awakening prediction using BAEP classification standard.Conclusions New BAEP grading could demonstrate cerebral dysfunction and probabilities of patients' awakening objectively and accurately. Key words: Craniocerebral trauma; Consciousness disorders; Awakening prediction; Brainstem auditory evoked potential
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