Role of Intraoperative Electroencephalography in Predicting Postoperative Delirium in Patients Undergoing Cardiovascular Surgeries.

Autor: Al-Qudah AM; Center of Clinical Neurophysiology, Department of Neurosurgery, University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh 15213-2582, Pennsylvania; UPMC Stroke Institute, Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA., Sivaguru S; Center of Clinical Neurophysiology, Department of Neurosurgery, University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh 15213-2582, Pennsylvania., Anetakis K; Center of Clinical Neurophysiology, Department of Neurosurgery, University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh 15213-2582, Pennsylvania., Crammond DJ; Center of Clinical Neurophysiology, Department of Neurosurgery, University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh 15213-2582, Pennsylvania., Balzer JR; Center of Clinical Neurophysiology, Department of Neurosurgery, University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh 15213-2582, Pennsylvania., Thirumala PD; Center of Clinical Neurophysiology, Department of Neurosurgery, University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh 15213-2582, Pennsylvania., Subramaniam K; Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh 15213-2582, Pennsylvania., Sadhasivam S; Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh 15213-2582, Pennsylvania., Shandal V; Center of Clinical Neurophysiology, Department of Neurosurgery, University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh 15213-2582, Pennsylvania. Electronic address: varun2422@gmail.com.
Jazyk: angličtina
Zdroj: Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology [Clin Neurophysiol] 2024 Aug; Vol. 164, pp. 40-46. Date of Electronic Publication: 2024 May 27.
DOI: 10.1016/j.clinph.2024.05.012
Abstrakt: Objective: To determine the utility of electroencephalography (EEG) in predicting postoperative delirium (POD) in patients who underwent cardiovascular surgeries with EEG monitoring.
Methods: A total of 1161 patients who underwent cardiovascular surgeries with EEG monitoring were included in the study, and their data were retrospectively reviewed. POD assessment was done utilizing Intensive Care Delirium Screening Checklist (ICDSC). Patients with a score of > 4 on ICDSC were diagnosed with POD.
Results: Of 1161 patients, 131 patients had EEG changes and 56 (42.74%) of 131 patients experienced POD. Of 1030 patients without EEG changes, 219 (21.26%) experienced POD. EEG showed specificity of 91.5% and negative predictive value of 78.7% in detecting POD. On multivariable analysis, EEG changes showed a strong association with POD (OR adj 1.97 CI (1.30-2.99), p = 0.001) with persistent EEG changes showing even a higher risk of developing POD (OR adj 2.65 (1.43-4.92), p = 0.002).
Conclusion: EEG change has specificity of 91.5% emphasizing the need for its implementation as a diagnostic tool for predicting POD. Patients with POD are two times more likely to experience significant EEG changes, especially persistent EEG changes when undergoing cardiovascular surgeries.
Significance: Intraoperative EEG can detect POD, and EEG changes based therapeutic interventions can mitigate POD.
(Copyright © 2024 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE