Mortality among patients with sepsis associated with a bispectral electroencephalography (BSEEG) score

Abstract

We have previously developed a bispectral electroencephalography (BSEEG) device, which was shown to be effective in detecting delirium and predicting patient outcomes. In this study we aimed to apply the BSEEG approach for a sepsis. This was a retrospective cohort study conducted at a single center. Sepsis-positive cases were identified based on retrospective chart review. EEG raw data and calculated BSEEG scores were obtained in the previous studies. The relationship between BSEEG scores and sepsis was analyzed, as well as the relationship among sepsis, BSEEG score, and mortality. Data were analyzed from 628 patients. The BSEEG score from the first encounter (1st BSEEG) showed a significant difference between patients with and without sepsis (p = 0.0062), although AUC was very small indicating that it is not suitable for detection purpose. Sepsis patients with high BSEEG scores showed the highest mortality, and non-sepsis patients with low BSEEG scores showed the lowest mortality. Mortality of non-sepsis patients with high BSEEG scores was as bad as that of sepsis patients with low BSEEG scores. Even adjusting for age, gender, comorbidity, and sepsis status, BSEEG remained a significant predictor of mortality (p = 0.008). These data are demonstrating its usefulness as a potential tool for identification of patients at high risk and management of sepsis.

Association of history of metformin use with delirium and mortality: A retrospective cohort study

“…All-cause mortality among the study participants were gathered from a review of medical records and obituary records as previously reported ( 26, 27, 29, 30, 34 ).…”

“…Our previously published work describes the details of study subjects and recruitment procedures (25)(26)(27)(28)(29)(30)(31)(32)(33)(34). Briefly, we identified eligible subjects 18 years old or older from patients at UIHC either admitted as inpatients or visiting the emergency room.…”

“…The procedures related to clinical data collection as well as definition of delirium status have been detailed in our reports published previously (25)(26)(27)(28)(29)(30)(31)(32)(33)(34). In brief, we reviewed hospital patient records and conducted patient interviews to collect medical history and demographic characteristics.…”

Sepsis-Induced Brain State Instability

“…Relative increases in delta and theta power and reduced spectral peak frequencies were found in septic patients [51][52][53][54]. Increased slowing was associated with poor outcomes, including delirium [54] and death [55]. In animal models, increased wake delta power [56], slowed EEG [57], and reduced theta frequencies have been described [26].…”

Sepsis-induced brain state instability

“…Increased delta and theta power, with high inter-individual variability, as well as a general slowing of oscillatory activity in the REM-like state under urethane is in line with slowing of EEG activity during awake, or wake-like states, described in sepsis patients (Götz et al, 2016; Rosengarten et al, 2012; Straver et al, 1998; Urdanibia-Centelles et al, 2021). Increased slowing was associated with poor outcomes, including delirium (Urdanibia-Centelles et al, 2021) and death (Yamanashi et al, 2021). In animal models, increased wake delta power (Kafa et al, 2010), slowed EEG (Kurita et al, 2010), and reduced theta frequencies have been described (Mamad et al, 2018).…”