Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, USA.
Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, USA.
Psychiatry Clin Neurosci. 2018 Dec;72(12):856-863. doi: 10.1111/pcn.12783. Epub 2018 Oct 25.
Delirium is common and dangerous among elderly inpatients; yet, it is underdiagnosed and thus undertreated. This study aimed to test the diagnostic characteristics of a noninvasive point-of-care device with two-channel (bispectral) electroencephalography (EEG) for the screening of delirium in the hospital.
Patients admitted to the University of Iowa Hospitals and Clinics were assessed for the presence of delirium with a clinical assessment, the Confusion Assessment Method for Intensive Care Unit and Delirium Rating Scale. Subsequently, we obtained a 10-min bispectral EEG (BSEEG) recording from a hand-held electroencephalogram device during hospitalization. We performed power spectral density analysis to differentiate between those patients with and without delirium.
Initially 45 subjects were used as a test dataset to establish a cut-off. The BSEEG index was determined to be a significant indicator of delirium, with sensitivity 80% and specificity 87.7%. An additional independent validation dataset with 24 patients confirmed the validity of the approach, with a sensitivity of 83.3% and specificity of 83.3%.
In this pilot study, the BSEEG method was able to distinguish delirious patients from non-delirious patients. Our data showed the feasibility of this technology for mass screening of delirium in the hospital.
谵妄在老年住院患者中很常见且很危险;然而,它的诊断率较低,因此治疗不足。本研究旨在测试一种具有双通道(双谱)脑电图(EEG)的非侵入性即时护理设备在医院筛查谵妄的诊断特征。
在爱荷华大学医院和诊所住院的患者使用临床评估、重症监护病房意识模糊评估方法和谵妄评定量表来评估是否存在谵妄。随后,我们使用手持式脑电图仪在住院期间获得了 10 分钟的双谱脑电图(BSEEG)记录。我们进行了功率谱密度分析,以区分有和没有谵妄的患者。
最初有 45 名患者作为测试数据集用于确定临界值。BSEEG 指数被确定为谵妄的一个重要指标,其敏感性为 80%,特异性为 87.7%。另外一个独立的 24 例验证数据集证实了该方法的有效性,敏感性为 83.3%,特异性为 83.3%。
在这项初步研究中,BSEEG 方法能够区分谵妄患者和非谵妄患者。我们的数据表明,这项技术有可能在医院对谵妄进行大规模筛查。