术中神经监测作为ICU动脉瘤夹闭术后谵妄的独立预测因子。

Q3 Neuroscience

eNeurologicalSci Pub Date : 2025-01-09 DOI:10.1016/j.ensci.2025.100549

Abdullah M. Al-Qudah , Pooja S. Tallapaneni , Donald J. Crammond , Jeffrey Balzer , Katherine M. Anetakis , Varun Shandal , Jingyuan Biaesch , Malik Ghannam , Neelesh Nadkarni , Bradley A. Gross , Michael Lang , Kathirvel Subramanium , Senthilkumar Sadhasivam , Parthasarathy D. Thirumala

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引用次数: 0

摘要

目的：本研究旨在评估术中显著神经生理监测（IONM）变化作为动脉瘤夹闭患者术后谵妄（POD）的独立预测指标的诊断准确性。方法：回顾性分析2019年至2021年273例开颅动脉瘤夹闭患者的IONM和临床资料。根据视觉资料和临床文献分别评估IONM和POD的显著变化。在ICU使用重症监护谵妄筛查清单（ICDSC）对POD进行多次评估。结果：273例IONM开颅患者中，有83例发生POD（30.4%）。42例患者出现明显的IONM变化，其中19例患者有POD（45.2%）。相比之下，231例患者在手术中没有IONM变化，其中64例（27.7%）患者有POD。多变量分析显示，显著的IONM变化与POD相关，OR: 2.09 （95% CI 1.01-4.43， p值：0.046）。体感诱发电位（SSEP）变化与POD显著相关（p值：0.044）。结论：在接受动脉瘤夹闭开颅手术的患者中，显著的IONM变化与POD风险增加有关。我们的研究结果为未来的研究和分析EEG和SSEP监测提供了强有力的基础，以发现并可能预防POD。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Intraoperative neuromonitoring as an independent predictor for postoperative delirium in ICU following aneurysm clipping

查看原文本刊更多论文

Intraoperative neuromonitoring as an independent predictor for postoperative delirium in ICU following aneurysm clipping

Objectives

This study aims to evaluate the diagnostic accuracy of significant intraoperative neurophysiological monitoring (IONM) changes as an independent predictor of postoperative delirium (POD) in patients undergoing aneurysm clipping.

Methods

IONM and clinical data from 273 patients who underwent craniotomy for aneurysm clipping from 2019 until 2021 were retrospectively reviewed. Significant IONM changes and POD were respectively evaluated based on visual review of data and clinical documentation. POD was assessed multiple times in the ICU using the Intensive Care Delirium Screening Checklist (ICDSC).

Results

Of the 273 patients undergoing craniotomy with IONM, 83 had POD (30.4 %). Significant IONM changes were noted in 42 patients, of which 19 patients had POD (45.2 %). In contrast, 231 patients had no IONM changes during surgery, of which 64 (27.7 %) patients had POD. Multivariable analysis showed that significant IONM changes were associated with POD, OR: 2.09 (95 % CI 1.01–4.43, p-value: 0.046). Additionally, somatosensory evoked potentials (SSEP) changes were significantly associated with POD (p-value: 0.044).

Conclusion

Significant IONM changes are associated with an increased risk of POD in patients undergoing craniotomy for aneurysm clipping. Our findings offer a strong basis for future research and analysis of EEG and SSEP monitoring to detect and possibly prevent POD.

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来源期刊

eNeurologicalSci Neuroscience-Neurology

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

62 days

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