Evaluation of point-of-care thumb-size bispectral electroencephalography device to quantify delirium severity and predict mortality

Abstract

Background We have developed the bispectral electroencephalography (BSEEG) method for detection of delirium and prediction of poor outcomes. Aims To improve the BSEEG method by introducing a new EEG device. Method In a prospective cohort study, EEG data were obtained and BSEEG scores were calculated. BSEEG scores were filtered on the basis of standard deviation (s.d.) values to exclude signals with high noise. Both non-filtered and s.d.-filtered BSEEG scores were analysed. BSEEG scores were compared with the results of three delirium screening scales: the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), the Delirium Rating Scale-Revised-98 (DRS) and the Delirium Observation Screening Scale (DOSS). Additionally, the 365-day mortalities and the length of stay (LOS) in the hospital were analysed. Results We enrolled 279 elderly participants and obtained 620 BSEEG recordings; 142 participants were categorised as BSEEG-positive, reflecting slower EEG activity. BSEEG scores were higher in the CAM-ICU-positive group than in the CAM-ICU-negative group. There were significant correlations between BSEEG scores and scores on the DRS and the DOSS. The mortality rate of the BSEEG-positive group was significantly higher than that of the BSEEG-negative group. The LOS of the BSEEG-positive group was longer compared with that of the BSEEG-negative group. BSEEG scores after s.d. filtering showed stronger correlations with delirium screening scores and more significant prediction of mortality. Conclusions We confirmed the usefulness of the BSEEG method for detection of delirium and of delirium severity, and prediction of patient outcomes with a new EEG device.

Association of history of metformin use with delirium and mortality: A retrospective cohort study

“…All-cause mortality among the study participants were gathered from a review of medical records and obituary records as previously reported ( 26, 27, 29, 30, 34 ).…”

“…Our previously published work describes the details of study subjects and recruitment procedures (25)(26)(27)(28)(29)(30)(31)(32)(33)(34). Briefly, we identified eligible subjects 18 years old or older from patients at UIHC either admitted as inpatients or visiting the emergency room.…”

“…The procedures related to clinical data collection as well as definition of delirium status have been detailed in our reports published previously (25)(26)(27)(28)(29)(30)(31)(32)(33)(34). In brief, we reviewed hospital patient records and conducted patient interviews to collect medical history and demographic characteristics.…”

Metformin use history and genome-wide DNA methylation profile: potential molecular mechanism for aging and longevity

“…Clinical variables were gathered through electronic medical chart review, patient interviews, and collateral information from family members [42][43][44][45] . Metformin use, insulin use, and type 2 diabetes mellitus (DM) history were obtained by using the search terms "metformin", "insulin", and "DM" or "diabetes", respectively 12 .…”

“…We have previously recruited patients at the University of Iowa Hospital and Clinics (UIHC) for a separate study related to delirium from January 2016 to March 2020 [42][43][44][45] . Among them, we used data from a subgroup of patients recruited from November 2017 to March 2020 who had blood samples collected and processed for the epigenetics analysis [46][47][48] .…”