Preoperative characterization of baseline EEG recordings for risk stratification of post-anesthesia care unit delirium

Jule Schüßler, Julian Ostertag, Marie Therese Georgii, Antonia Fleischmann, Gerhard Schneider, Stefanie Pilge, Matthias Kreuzer

Publikation: Beitrag in FachzeitschriftArtikelBegutachtung

10 Zitate (Scopus)

Abstract

Study objective: Delirium in the post-anesthesia care unit (PACU-D) presents a serious condition with a high medical and socioeconomic impact. In particular, PACU-D is among common postoperative complications of elderly patients. As PACU-D may be associated with postoperative delirium, early detection of at-risk patients and strategies to prevent PACU-D are important. We characterized EEG baseline signatures of patients who developed PACU-D following surgery and general anesthesia and patients who did not. Design and setting: We conducted a post-hoc analysis of preoperative EEG recordings between patients with and without PACU-D, as indicated by positive bCAM scores post general anesthesia and surgery. Patients and measurements: Preoperative baseline EEG recordings from 89 patients were recorded at controlled eyes-open (focused wakefulness) and eyes-closed (relaxed wakefulness) conditions. We computed power spectral densities, permutation entropy, spectral entropy and spectral edge frequency to see if these parameters can reflect potential baseline EEG differences between PACU-D (31.5%) and noPACU-D (68.5%) patients. Wilcoxon's Rank Sum Test as well as AUC values were used to determine statistical significance. Main results: Baseline EEG recordings showed significant differences between PACU-D and noPACU-D patients preoperatively. Compared to the noPACU-D group, PACU-D patients presented with lower power in higher frequencies during relaxed and focused wakefulness alike. These differences in power led to AUC values of 0.73 [0.59;0.85] (permutation entropy) and 0.72 [0.61;0.83] (spectral edge frequency) indicative of a “fair” performance to separate patients with and without PACU-D. Conclusions: The baseline EEG of relaxed wakefulness as well as focused wakefulness may be used to assess the risk of developing PACU-D following surgery under general anesthesia. Moreover, routinely used monitoring parameters capture these differences as well, potentially allowing an easy transfer to clinical settings.

OriginalspracheEnglisch
Aufsatznummer111058
FachzeitschriftJournal of Clinical Anesthesia
Jahrgang86
DOIs
PublikationsstatusVeröffentlicht - Juni 2023

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