TY - JOUR
T1 - Delirium detection using relative delta power based on 1 minute single-channel EEG: a multicentre study
AU - Dutch Delirium Detection Study Group
AU - Numan, T.
AU - van den Boogaard, M.
AU - Kamper, A. M.
AU - Rood, P. J. T.
AU - Peelen, L. M.
AU - Slooter, A. J. C.
AU - Abawi, Masieh
AU - van den Boogaard, Mark
AU - Claassen, Jurgen A. HR.
AU - Coesmans, Michael
AU - Dautzenberg, Paul
AU - Dhondt, Ton A. DF.
AU - Diraoui, Shiraz B.
AU - Eikelenboom, Piet
AU - Emmelot-Vonk, Marielle H.
AU - Faaij, Richard A.
AU - van Gool, Willem A.
AU - Groot, Erwin R.
AU - Hagestein-de Bruijn, Carla
AU - Hovens, Jacqueline G. FM.
AU - van der Jagt, Mathieu
AU - de Jonghe, Anne-Marieke
AU - Kamper, Adriaan M.
AU - Koek, Huiberdine L.
AU - van der Kooi, Arendina W.
AU - Kromkamp, Marjan
AU - Lagro, Joep
AU - Leentjens, Albert F. G.
AU - Lefeber, Geert J.
AU - Leijten, Frans S.
AU - Leue, Carsten
AU - de Man, Tjarda
AU - van Marum, Robert J.
AU - van der Mast, Roos C.
AU - van Munster, Barbara C.
AU - Numan, Tianne
AU - Osse, Robert Jan
AU - Barbara Portier, C.
AU - Rius Ottenheim, Nathaly
AU - Rood, Paul J. T.
AU - Röder, Christian H.
AU - Schoon, Yvonne
AU - Slooter, Arjen J. C.
AU - Tromp, Arjen
AU - van der Vlugt, Joris B.
AU - Vondeling, Ariël M.
AU - Wassenaar, Annelies
AU - Weinstein, Henry
AU - Witlox, Joost
AU - van Zanten, Jeroen S.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background: Delirium is frequently unrecognised. EEG shows slower frequencies (i.e. below 4 Hz) during delirium, which might be useful in improving delirium recognition. We studied the discriminative performance of a brief single-channel EEG recording for delirium detection in an independent cohort of patients. Methods: In this prospective, multicentre study, postoperative patients aged ≥60 yr were included (n=159). Before operation and during the first 3 postoperative days, patients underwent a 5-min EEG recording, followed by a video-recorded standardised cognitive assessment. Two or, in case of disagreement, three delirium experts classified each postoperative day based on the video and chart review. Relative delta power (1–4 Hz) was based on 1-min artifact-free EEG. The diagnostic value of the relative delta power was evaluated by the area under the receiver operating characteristic curve (AUROC), using the expert classification as the gold standard. Results: Experts classified 84 (23.3%) postoperative days as either delirium or possible delirium, and 276 (76.7%) non-delirium days. The AUROC of the relative EEG delta power was 0.75 [95% confidence interval (CI) 0.69–0.82]. Exploratory analysis showed that relative power from 1 to 6 Hz had significantly higher AUROC (0.78, 95% CI 0.72–0.84, P=0.014). Conclusions: Delirium/possible delirium can be detected in older postoperative patients based on a single-channel EEG recording that can be automatically analysed. This objective detection method with a continuous scale instead of a dichotomised outcome is a promising approach for routine detection of delirium. Clinical trial registration: NCT02404181.
AB - Background: Delirium is frequently unrecognised. EEG shows slower frequencies (i.e. below 4 Hz) during delirium, which might be useful in improving delirium recognition. We studied the discriminative performance of a brief single-channel EEG recording for delirium detection in an independent cohort of patients. Methods: In this prospective, multicentre study, postoperative patients aged ≥60 yr were included (n=159). Before operation and during the first 3 postoperative days, patients underwent a 5-min EEG recording, followed by a video-recorded standardised cognitive assessment. Two or, in case of disagreement, three delirium experts classified each postoperative day based on the video and chart review. Relative delta power (1–4 Hz) was based on 1-min artifact-free EEG. The diagnostic value of the relative delta power was evaluated by the area under the receiver operating characteristic curve (AUROC), using the expert classification as the gold standard. Results: Experts classified 84 (23.3%) postoperative days as either delirium or possible delirium, and 276 (76.7%) non-delirium days. The AUROC of the relative EEG delta power was 0.75 [95% confidence interval (CI) 0.69–0.82]. Exploratory analysis showed that relative power from 1 to 6 Hz had significantly higher AUROC (0.78, 95% CI 0.72–0.84, P=0.014). Conclusions: Delirium/possible delirium can be detected in older postoperative patients based on a single-channel EEG recording that can be automatically analysed. This objective detection method with a continuous scale instead of a dichotomised outcome is a promising approach for routine detection of delirium. Clinical trial registration: NCT02404181.
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U2 - https://doi.org/10.1016/j.bja.2018.08.021
DO - https://doi.org/10.1016/j.bja.2018.08.021
M3 - Article
C2 - 30579407
SN - 0007-0912
VL - 122
SP - 60
EP - 68
JO - British Journal of Anaesthesia
JF - British Journal of Anaesthesia
IS - 1
ER -