Journal article
Intraoperative neuromonitoring as an independent predictor for postoperative delirium in craniotomy for aneurysm clipping
eNeurologicalSci, Vol.38, 100549
03/2025
DOI: 10.1016/j.ensci.2025.100549
PMCID: PMC11786857
PMID: 39895968
Abstract
The primary aim of the study is to determine the diagnostic accuracy of significant changes in intraoperative neurophysiological monitoring (IONM) as an independent predictor for post operative delirium (POD) in patients undergoing craniotomy for aneurysm clipping.
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 using the Intensive Care Delirium Screening Checklist (ICDSC).
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 delirium (45.2 %). In contrast, 231 patients had no IONM changes during surgery, of which 64 (27.7 %) patients had delirium. 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).
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.
•Significant Intraoperative neurophysiological monitoring (IONM) changes were associated with an increased of 2 folds in risk of Postoperative Delirium (POD) in patients undergoing craniotomy for aneurysm clipping.•SSEP and EEG changes had specificity of 96 % in detecting POD.•Intraoperative hypotension was not significantly associated with POD in our study.
Details
- Title: Subtitle
- Intraoperative neuromonitoring as an independent predictor for postoperative delirium in craniotomy for aneurysm clipping
- Creators
- Abdullah Al Qudah - University of Pittsburgh Medical CenterPooja S. Tallapaneni - University of Pittsburgh Medical CenterDonald J. Crammond - University of Pittsburgh Medical CenterJeffrey Balzer - University of Pittsburgh Medical CenterKatherine M. Anetakis - University of Pittsburgh Medical CenterVarun Shandal - University of Pittsburgh Medical CenterJingyuan Biaesch - University of Pittsburgh Medical CenterMalik Ghannam - University of IowaNeelesh Nadkarni - University of Pittsburgh Medical CenterBradley A. Groos - University of Pittsburgh Medical CenterMichael Lang - University of Pittsburgh Medical CenterKathirvel Subramanium - University of Pittsburgh Medical CenterSenthilkumar Sadhasivam - University of Pittsburgh Medical CenterParthasarathy D. Thirumala - University of Pittsburgh Medical Center
- Resource Type
- Journal article
- Publication Details
- eNeurologicalSci, Vol.38, 100549
- DOI
- 10.1016/j.ensci.2025.100549
- PMID
- 39895968
- PMCID
- PMC11786857
- NLM abbreviation
- eNeurologicalSci
- ISSN
- 2405-6502
- eISSN
- 2405-6502
- Publisher
- Elsevier B.V
- Language
- English
- Electronic publication date
- 01/09/2025
- Date published
- 03/2025
- Academic Unit
- Neurology
- Record Identifier
- 9984773419702771
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