Delirium detection using relative delta power based on 1 minute single-channel EEG: a multicentre study

Dutch Delirium Detection Study Group

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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.
Original languageEnglish
Pages (from-to)60-68
Number of pages9
JournalBritish Journal of Anaesthesia
Volume122
Issue number1
DOIs
Publication statusPublished - Jan 2019

Cite this

@article{1ac15e28086a4ece81f42fa8a020969e,
title = "Delirium detection using relative delta power based on 1 minute single-channel EEG: a multicentre study",
abstract = "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.",
author = "{Dutch Delirium Detection Study Group} and T. Numan and {van den Boogaard}, M. and Kamper, {A. M.} and Rood, {P. J. T.} and Peelen, {L. M.} and Slooter, {A. J. C.} and Masieh Abawi and {van den Boogaard}, Mark and Claassen, {Jurgen A. HR.} and Michael Coesmans and Paul Dautzenberg and Dhondt, {Ton A. DF.} and Diraoui, {Shiraz B.} and Piet Eikelenboom and Emmelot-Vonk, {Marielle H.} and Faaij, {Richard A.} and {van Gool}, {Willem A.} and Groot, {Erwin R.} and {Hagestein-de Bruijn}, Carla and Hovens, {Jacqueline G. FM.} and {van der Jagt}, Mathieu and {de Jonghe}, Anne-Marieke and Kamper, {Adriaan M.} and Koek, {Huiberdine L.} and {van der Kooi}, {Arendina W.} and Marjan Kromkamp and Joep Lagro and Leentjens, {Albert F. G.} and Lefeber, {Geert J.} and Leijten, {Frans S.} and Carsten Leue and {de Man}, Tjarda and {van Marum}, {Robert J.} and {van der Mast}, {Roos C.} and {van Munster}, {Barbara C.} and Tianne Numan and Osse, {Robert Jan} and {Barbara Portier}, C. and {Rius Ottenheim}, Nathaly and Rood, {Paul J. T.} and R{\"o}der, {Christian H.} and Yvonne Schoon and Slooter, {Arjen J. C.} and Arjen Tromp and {van der Vlugt}, {Joris B.} and Vondeling, {Ari{\"e}l M.} and Annelies Wassenaar and Henry Weinstein and Joost Witlox and {van Zanten}, {Jeroen S.}",
year = "2019",
month = "1",
doi = "10.1016/j.bja.2018.08.021",
language = "English",
volume = "122",
pages = "60--68",
journal = "British Journal of Anaesthesia",
issn = "0007-0912",
publisher = "Oxford University Press",
number = "1",

}

Delirium detection using relative delta power based on 1 minute single-channel EEG: a multicentre study. / Dutch Delirium Detection Study Group.

In: British Journal of Anaesthesia, Vol. 122, No. 1, 01.2019, p. 60-68.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Delirium detection using relative delta power based on 1 minute single-channel EEG: a multicentre study

AU - Dutch Delirium Detection Study Group

AU - Numan, T.

AU - van den Boogaard, M.

AU - Kamper, A. M.

AU - Rood, P. J. T.

AU - Peelen, L. M.

AU - Slooter, A. J. C.

AU - Abawi, Masieh

AU - van den Boogaard, Mark

AU - Claassen, Jurgen A. HR.

AU - Coesmans, Michael

AU - Dautzenberg, Paul

AU - Dhondt, Ton A. DF.

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 G. FM.

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 F. G.

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, Tianne

AU - Osse, Robert Jan

AU - Barbara Portier, C.

AU - Rius Ottenheim, Nathaly

AU - Rood, Paul J. T.

AU - Röder, Christian H.

AU - Schoon, Yvonne

AU - Slooter, Arjen J. C.

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.

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.

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U2 - 10.1016/j.bja.2018.08.021

DO - 10.1016/j.bja.2018.08.021

M3 - Article

VL - 122

SP - 60

EP - 68

JO - British Journal of Anaesthesia

JF - British Journal of Anaesthesia

SN - 0007-0912

IS - 1

ER -