定量脑电图预测 A 型主动脉夹层患者神经功能障碍：一项前瞻性观察研究。

Quantitative Electroencephalography for Predication of Neurological Dysfunction in Type A Aortic Dissection: A Prospective Observational Study.

机构信息

Department of Cardiac Surgery Nanjing Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Jiangsu China.

Department of Cardiac Surgery Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School Jiangsu China.

出版信息

J Am Heart Assoc. 2024 Oct;13(19):e034351. doi: 10.1161/JAHA.124.034351. Epub 2024 Sep 18.

DOI:10.1161/JAHA.124.034351

PMID:39291506

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11681453/

Abstract

BACKGROUND

Type A aortic dissection presents challenges with postoperative cerebral complications, and this study evaluates the predictive value of quantitative electroencephalography for perioperative brain function prognosis.

METHODS AND RESULTS

Amplitude-integrated electroencephalography (aEEG) processes raw signals through filtering, amplitude integration, and time compression, displaying the data in a semilogarithmic format. Using this method, postoperative relative band power (post-RBP) α% and dynamic aEEG (ΔaEEG) grade were significantly associated with neurological dysfunction in univariate and multivariable analyses, with area under the receiver operating characteristic curve of 0.876 (95% CI, 0.825-0.926) for the combined model. Postoperative relative band power α% and ΔaEEG were significantly associated with adverse outcomes, with area under the receiver operating characteristic curve of 0.903 (95% CI, 0.835-0.971) for the combined model. Postoperative relative band power α% and ΔaEEG were significantly associated with transient neurological dysfunction and stroke, with areas under the receiver operating characteristic curve of 0.818 (95% CI, 0.760-0.876) and 0.868 (95% CI, 0.810-0.926) for transient neurological dysfunction, and 0.815 (95% CI, 0.743-0.886) and 0.831 (95% CI, 0.746-0.916) for stroke. Among 56 patients, the Alberta Stroke Program Early Computed Tomography score was superior to ΔaEEG in predicting neurological outcomes (area under the receiver operating characteristic curve of 0.872 versus 0.708 [95% CI, 0.633-0.783]; <0.05).

CONCLUSIONS

Perioperative quantitative electroencephalography monitoring offers valuable insights into brain function changes in patients with type A aortic dissection. ∆aEEG grades can aid in early detection of adverse outcomes, while postoperative relative band power and ∆aEEG grades predict transient neurological dysfunction. Quantitative electroencephalography can assist cardiac surgeons in assessing brain function and improving outcomes in patients with type A aortic dissection.

REGISTRATION

URL: https://www.chictr.org.cn; Unique identifier: ChiCTR2200055980.

摘要

背景

A型主动脉夹层术后存在脑并发症的挑战，本研究评估定量脑电图对围术期脑功能预后的预测价值。

方法和结果

振幅整合脑电图（aEEG）通过滤波、幅度整合和时间压缩对原始信号进行处理，以半对数格式显示数据。使用该方法，术后相对带宽功率（post-RBP）α%和动态 aEEG（ΔaEEG）分级在单变量和多变量分析中与神经功能障碍显著相关，联合模型的受试者工作特征曲线下面积为 0.876（95%CI，0.825-0.926）。术后相对带宽功率α%和ΔaEEG 与不良结局显著相关，联合模型的受试者工作特征曲线下面积为 0.903（95%CI，0.835-0.971）。术后相对带宽功率α%和ΔaEEG 与短暂性神经功能障碍和中风显著相关，受试者工作特征曲线下面积分别为 0.818（95%CI，0.760-0.876）和 0.868（95%CI，0.810-0.926）用于短暂性神经功能障碍，0.815（95%CI，0.743-0.886）和 0.831（95%CI，0.746-0.916）用于中风。在 56 例患者中，阿尔伯塔卒中计划早期计算机断层扫描评分在预测神经结局方面优于ΔaEEG（受试者工作特征曲线下面积为 0.872 与 0.708（95%CI，0.633-0.783）；<0.05）。