| Objective: To explore the clinical value of mismatched negative wave (MMN) and P300 combined with coma recovery scale (CRS-R) in predicting the prognosis of children with disorder of consciousness（DOC）. Methods: The clinical data of 42 children with DOC were studied retrospectively. The basic data, the score of revised coma recovery scale (CRS-R) and the results of event-related potential (ERP) were recorded. The end point of the study was 6 months after admission, leaving minimally conscious state or death. The prognosis was followed up by bedside evaluation or telephone follow-up according to CRS-R score. The clinical data, scale and ERP index were analyzed by univariate analysis, and the indexes related to prognosis were screened. Binary Logistic regression analysis was used to establish a regression model, draw ROC curve, and judge the value of prognosis evaluation. Results: The univariate analysis showed that there were significant differences in CRS-R score, latency and amplitude of MMN, amplitude of P300. Multivariate Logistic regression analysis showed that for every 10 ms increase in MMN latency, the probability of awakening was 0.548 times higher than that of the original (OR=0.548, 95%CI: 0.344-0.872, P=0.011), and the probability of conscious prognosis increased 0.34 times when the amplitude of MMN increased (OR=1.34, 95%CI: 1.060-1.695, P=0.014). When the amplitude of P300 increased with 0.1 uV, the probability of clear prognosis increased by 0.261 times (OR=1.261, 95%CI: 0.986-1.612, P=0.064), and the model was tested: χ2=9.917, P=0.271, which showed a good fitting effect. By drawing the ROC curve, it was found that the AUC value of the combination of MMN latency, MMN amplitude and P300 amplitude was the highest, 0.938 (P<0.001). Conclusion: The latency and amplitude of MMN and the amplitude of P300 are related to the prognosis of children with DOC. The combined detection of the three indexes has the highest accuracy, specificity and sensitivity, which can provide a basis for judging the prognosis of children with DOC and has a certain clinical application value. |
