■谵妄是一种以急性认知障碍为特征的普遍但未被诊断的疾病。各种筛选工具可用,包括混淆评估方法(CAM)和4A测试(4AT)。然而,这些评估的结果可能因评估者而异。因此,我们调查了脑电图(EEG)在谵妄中的客观应用及其临床关联和预测价值.
■这项横断面观察研究是在CanselorTuankuMuhriz医院进行的,Kebangsaan大学,马来西亚,从2021年4月到2023年4月。这项研究包括年龄≥18岁并初步诊断为谵妄的患者。收集人口统计学和临床数据以及由认证的神经科医师评估的EEG记录,以对异常进行分类,并比较有或没有EEG异常的谵妄患者之间的相关因素。
■招募了120名患者,80.0%的人显示脑电图异常,主要是广泛性减慢(中度至重度)和主要是广泛性减慢(轻度至重度),并以θ活性为特征。年龄与脑电图异常显著相关,75岁及以上的患者发病率最高(88.2%)。CAM评分与EEG异常密切相关(r=0.639,P<0.001),是EEG异常的预测因子(P<0.012),这表明脑电图可以补充谵妄的临床评估。Richmond躁动和镇静量表(RASS)评分(r=-0.452,P<0.001)和Barthel指数(BI)(r=-0.582,P<0.001)与脑电图异常呈负相关。此外,住院时间较长与EEG异常相关(r=0.250,P=0.006),并可作为此类变化的预测因子(P=0.030).
■脑电图异常在谵妄患者中普遍存在,尤其是老年患者。CAM评分和住院时间是EEG异常的有价值的预测因子。脑电图可以成为增强谵妄诊断和预后的客观工具。从而促进及时干预。
为什么要进行这项研究?在有各种医疗问题的患者中经常观察到混乱。有几种测试可以帮助评估这些患者,以查看存在的症状是否构成谵妄。然而,尽管有可用的工具,但仍有可能难以识别谵妄。脑电图(EEG)可以是辅助医务人员诊断谵妄的另一种选择。在这项研究中,我们研究了EEG在鉴定谵妄及其临床关联中的应用.研究人员做了什么?我们的团队研究了在2年内因各种医学问题而入院的患者中使用EEG的情况。我们收集了相关的临床数据,并对每位参与者进行了脑电图检查。研究人员发现了什么?共有120名参与者参与了这项研究。我们在80%的患者中观察到异常的EEG发现,大多数患者表现出广泛性减慢。与脑电图异常相关的因素是年龄增长,积极的混淆评估方法(CAM),和住院时间。这些发现意味着什么?由于该服务并不广泛可用,用EEG替代现有的临床评估工具是不切实际的.然而,我们不能忽视识别谵妄的重要性,因为它与不良临床结局相关.因此,对于可能进行脑电图的中心来说,如果出现任何疑问,它可以用作诊断谵妄的辅助手段。
UNASSIGNED: Delirium is a prevalent yet underdiagnosed disorder characterized by acute cognitive impairment. Various screening tools are available, including the Confusion Assessment Method (CAM) and 4 A\'s test (4AT). However, the results of these assessments may vary among raters. Therefore, we investigated the objective use of electroencephalography (EEG) in delirium and its clinical associations and predictive value.
UNASSIGNED: This cross-sectional observational study was conducted at Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan, Malaysia, from April 2021 to April 2023. This study included patients aged ≥18 years with a preliminary diagnosis of delirium. Demographic and clinical data were collected along with EEG recordings evaluated by certified neurologists to classify abnormalities and compare the associated factors between patients with delirium with or without EEG abnormalities.
UNASSIGNED: One hundred and twenty patients were recruited, with 80.0% displaying EEG abnormalities, mostly generalized slowing (moderate to severe) and primarily generalized slowing (mild to severe), and were characterized by theta activity. Age was significantly associated with EEG abnormalities, with patients aged 75 and older demonstrating the highest incidence (88.2%). The CAM scores were strongly correlated with EEG abnormalities (r = 0.639, P < 0.001) and was a predictor of EEG abnormalities (P < 0.012), indicating that EEG can complement clinical assessments for delirium. The Richmond Agitation and Sedation Scale (RASS) scores (r = -0.452, P < 0.001) and Barthel index (BI) (r = -0.582, P < 0.001) were negatively correlated with EEG abnormalities. Additionally, a longer hospitalization duration was associated with EEG abnormalities (r = 0.250, P = 0.006) and emerged as a predictor of such changes (P = 0.030).
UNASSIGNED: EEG abnormalities are prevalent in patients with delirium, particularly in elderly patients. CAM scores and the duration of hospitalization are valuable predictors of EEG abnormalities. EEG can be an objective tool for enhancing delirium diagnosis and prognosis, thereby facilitating timely interventions.
Why was the study done? Confusion is frequently observed among patients presenting with various medical issues. There are several tests available to assist in assessment of these patients to see if the symptoms present constitute delirium. However, there may be occasions where identifying delirium is difficult despite the tools available. Electroencephalography (EEG) may be another option to assist medical personnel in diagnosing delirium. In this study, we examine the use of EEG in identification of delirium and its clinical associations. What did the researchers do? Our team studied the use of EEG in patients admitted for various medical issues with symptoms suggestive of delirium over a 2-year period. We collected relevant clinical data and performed EEG for each participant. What did the researchers find? A total of 120 participants were involved in the study. We observe abnormal EEG findings in 80% of patients with the majority showing generalized slowing. The factors associated with EEG abnormalities are advancing age, positive Confusion Assessment Method (CAM), and duration of hospitalization. What do the findings mean? As the service is not widely available, it would not be practical to substitute existing clinical assessment tools with EEG. However, we cannot discount the importance of identifying delirium due to its association with poor clinical outcomes. Therefore, for centers that may perform EEG, it may be used as an adjunct in diagnosing delirium should any doubts arise.