A mainstay in the diagnosis and care of hospitalized patients is the assessment of mental status. Changes in mental status can have broad clinical significance, and while some patients are admitted with mental status changes, nearly half of the patients who experience delirium in the hospital develop it after admission in a manner that is hard to predict on the level of individual patients. Patients with altered mental status such as delirium have worse clinical outcomes, suggesting that early monitoring of mental status can identify important clinical populations who may benefit from targeted delirium prevention and intervention. Delirium remains under-recognized in the hospital, in part due to its fluctuating nature. Typically, mental status is assessed sporadically, perhaps once a day, through intermittent and subjective clinical interactions. As such, there is a clear clinical need for objective, continuous methods to monitor mental status. Such methods could potentially improve detection of delirium, potentially even predicting it prior to clinical recognition, and therefore direct multimodal delirium prevention and intervention strategies when most effective-before delirium becomes fully manifest. In this proposal we plan on testing noninvasive, continuous monitors of mental status in the inpatient setting, primarily through the use of EEG.
Study Type
OBSERVATIONAL
Enrollment
350
EEG monitoring of brain rhythms
Massachusetts General Hospital
Boston, Massachusetts, United States
Delirium Severity
Inpatient Delirium as assessed by the 3D-CAM-S
Time frame: Daily during the time of EEG recording up to 7 days
EEG
Relative EEG power in the delta \& theta bands
Time frame: Daily during the time of EEG recording up to 7 days
Functional status
Functional status as assessed by the Glasgow Outcome Score (1-5, with lower numbers less favorable outcomes and higher numbers more favorable outcomes)
Time frame: 3 months after completion of EEG recording
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