Investigating how electroencephalogram measures associate with delirium: A systematic review

Boord, Monique S.; Moezzi, Bahar; Davis, Daniel; Ross, Tyler J.; Coussens, Scott; Psaltis, Peter J.; Bourke, Alice; Keage, Hannah A.D.

doi:10.1016/j.clinph.2020.09.009

Cited by 43 publications

(39 citation statements)

References 87 publications

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“…Further research evaluating the use of techniques such as electroencephalogram studies is needed. 26 Nevertheless, we consider that our methodology demonstrates feasibility in diagnosing delirium retrospectively from medical notes, which would not be possible using a biological definition. This enables the determination of the effect of delirium on outcomes in studies where this was not measured prospectively.…”

Section: Discussionmentioning

confidence: 99%

Retrospective delirium ascertainment from case notes: a retrospective cohort study

2021

BMJ Open

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ObjectivesThis study sets out to ascertain if recognition of delirium impacts on patient outcomes.DesignRetrospective cohort study.SettingUnscheduled admissions to acute care trust/secondary care UK hospitals.ParticipantsSix hundred and fifty-six older adults aged ≥65 years admitted on 14 September 2018.MeasurementsDelirium was ascertained retrospectively from case notes using medical notes. Documented delirium was classified as recognised delirium and retrospectively ascertained delirium was classified as unrecognised delirium.Primary and secondary outcome measuresPrimary outcome measure: inpatient mortality. Secondary outcome measures: length of stay, discharge destination.ResultsDelirium was present in 21.1% (132/626) of patients at any point during admission. The presence of delirium was associated with increased mortality (HR 2.65, CI 1.40 to 5.01). Recognition of delirium did not significantly impact on outcomes.ConclusionsDelirium is associated with adverse outcomes in hospitalised older adults. However, there is insufficient evidence that recognition of delirium affects outcomes. However, delirium recognition presents an opportunity to discuss a person’s overall prognosis and discuss this with the patient and their family. Further research is needed to assess the pathophysiology of delirium to enable development of targeted interventions towards improved outcomes in patients with delirium.

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Section: Discussionmentioning

confidence: 99%

Retrospective delirium ascertainment from case notes: a retrospective cohort study

2021

BMJ Open

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“… 84 Therefore, EEG slowing (characterized by increases in delta and theta power and triphasic waves) and reduced functional connectivity can distinguish patients with and without delirium. 85 EEG also has diagnostic utility particularly to identify mental alterations due to non-convulsive status epilepticus which may present as delirium.…”

Section: Screening and Diagnosismentioning

confidence: 99%

Current Challenges in the Recognition and Management of Delirium Superimposed on Dementia

Nitchingham¹,

Caplan²

2021

NDT

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“… 21 EEG has successfully provided neural markers of numerous clinical disorders, including schizophrenia, 22–24 coma, 25 26 psychosis 27 28 and depression, 29 30 and is a promising approach to capture delirium vulnerability. 31 …”

Section: Introductionmentioning

confidence: 99%

“…Our recent systematic review summarised EEG associations with delirium relative to time, that is, before (vulnerability for delirium), during, and after delirium. 31 These time-points are relevant as the EEG can be affected by surgical and situational factors. For example, EEG recorded during surgery is known to be affected by anaesthesia and other events including hypothermia.…”

Section: Introductionmentioning

confidence: 99%

DelIrium VULnerability in GEriatrics (DIVULGE) study: a protocol for a prospective observational study of electroencephalogram associations with incident postoperative delirium

et al. 2021

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IntroductionDelirium is a neurocognitive disorder common in older adults in acute care settings. Those who develop delirium are at an increased risk of dementia, cognitive decline and death. Electroencephalography (EEG) during delirium in older adults is characterised by slowing and reduced functional connectivity, but markers of vulnerability are poorly described. We aim to identify EEG spectral power and event-related potential (ERP) markers of incident delirium in older adults to understand neural mechanisms of delirium vulnerability. Characterising delirium vulnerability will provide substantial theoretical advances and outcomes have the potential to be translated into delirium risk assessment tools.Methods and analysisWe will record EEG in 90 participants over 65 years of age prior to elective coronary artery bypass grafting (CABG) or transcatheter aortic valve implantation (TAVI). We will record 4-minutes of resting state (eyes open and eyes closed) and a 5-minute frequency auditory oddball paradigm. Outcome measures will include frequency band power, 1/f offset and slope, and ERP amplitude measures. Participants will undergo cognitive and EEG testing before their elective procedures and daily postoperative delirium assessments. Group allocation will be done retrospectively by linking preoperative EEG data according to postoperative delirium status (presence, severity, duration and subtype).Ethics and disseminationThis study is approved by the Human Research Ethics Committee of the Royal Adelaide Hospital, Central Adelaide Local Health Network and the University of South Australia Human Ethics Committee. Findings will be disseminated through peer-reviewed journal articles and presentations at national and international conferences.Trial registration numberACTRN12618001114235 and ACTRN12618000799257.

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Investigating how electroencephalogram measures associate with delirium: A systematic review

Cited by 43 publications

References 87 publications

Retrospective delirium ascertainment from case notes: a retrospective cohort study

Retrospective delirium ascertainment from case notes: a retrospective cohort study

Current Challenges in the Recognition and Management of Delirium Superimposed on Dementia

DelIrium VULnerability in GEriatrics (DIVULGE) study: a protocol for a prospective observational study of electroencephalogram associations with incident postoperative delirium

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