TY - JOUR
T1 - Delirium detection using relative delta power based on 1 minute single-channel EEG
T2 - a multicentre study
AU - Numan, T.
AU - van den Boogaard, M.
AU - Kamper, A. M.
AU - Rood, P. J.T.
AU - Peelen, L. M.
AU - Slooter, Arjen JC
AU - Abawi, Masieh
AU - van den Boogaard, Mark
AU - Claassen, Jurgen AHR
AU - Coesmans, Michael
AU - Dautzenberg, Paul
AU - Dhondt, Ton ADF
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 GFM
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 FG
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, T.
AU - Osse, Robert Jan
AU - Barbara Portier, C.
AU - Rius Ottenheim, Nathaly
AU - Rood, Paul JT
AU - Röder, Christian H.
AU - Schoon, Yvonne
AU - Slooter, Arjen JC
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.
N1 - Funding Information:
Clinical Research Award ESICM, Technology Foundation STW (14066), European Union (H2020-PHC-12-2014-672974) and institutional support.
Publisher Copyright:
© 2018 British Journal of Anaesthesia
PY - 2019/1
Y1 - 2019/1
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.
KW - Aged
KW - Aged, 80 and over
KW - Algorithms
KW - Delirium/diagnosis
KW - Electroencephalography/methods
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Monitoring, Physiologic/methods
KW - Postoperative Care/methods
KW - Postoperative Complications/diagnosis
KW - ROC Curve
KW - Reproducibility of Results
KW - Signal Processing, Computer-Assisted
UR - http://www.scopus.com/inward/record.url?scp=85054078214&partnerID=8YFLogxK
U2 - 10.1016/j.bja.2018.08.021
DO - 10.1016/j.bja.2018.08.021
M3 - Article
C2 - 30579407
AN - SCOPUS:85054078214
SN - 0007-0912
VL - 122
SP - 60
EP - 68
JO - British Journal of Anaesthesia
JF - British Journal of Anaesthesia
IS - 1
ER -