Correlation Of Event-related Potential And Delirium In Critically Ill Patients

Objective:To explore the correlation between event-related potential(ERP)and delirium in ICU patients,to provide an objective basis for the diagnosis of delirium.Methods:A total of 241 patients who were admitted to the emergency ICU of Chenggong Hospital,Kunming Medical University First Affiliated Hospital from January 2019 to January 2020 were screened continuously,and 107 patients who met the inclusion criteria were selected as the research object.Patients were assessed by CAM-ICU(Confusion Assessment Method for the ICU)and divided into delirium group and non-delirium group.Complete the medical history collection within 24 hours after admission,record the patient's general information(age,gender,disease,etc.)and record the Glasgow Coma Scale(GCS),RASS evaluation,APACHEII score,inflammatory cytokines,whether or not tracheal intubation is required,Whether there is basic information such as sedation and mechanical ventilation.On the day of admission,the patient was evaluated for delirium using the CAM-ICU method.Subsequent delirium evaluation will be continued.The two monitoring intervals will be 6 hours,and event-related potential monitoring will be performed at the same time.amplitude.In this study,the mean ± standard deviation(X±S)or median(quartile)[Median(P25,P75)]was used to describe the quantitative data.The difference between the two groups was analyzed using two independent sample t tests or ranks.And test;qualitative data is described by the number of cases(composition ratio),and the difference in composition ratio between different groups is compared using the test or Fisher's exact probability method.Logistic regression is used to calculate the prediction probability of the joint indicator,and the ROC curve is used to evaluate the diagnostic effect of the indicator.Assuming that the tests are all two-sided tests,the test level is set to ?=0.05,P?0.05 is considered statistically significant.The above analysis is implemented using SPSS22.0 software package.Results:A total of 35 of 107 patients had delirium during their stay in the ICU,with an incidence rate of 32.7%(35/107).Among all patients enrolled,the average GCS score of delirium patients was not significantly different from that of non-delirium patients(P>0.05).The average APACHE ? score of delirium patients was 27.5±3.1 points,which was significantly higher than that of non-delirium patients(19.3±3.0 points).),the difference is statistically significant(P<0.001).The average latency of the event-related potential P300 in delirium patients was significantly higher than that in non-delirium patients,and the average amplitude was lower than that in non-delirium patients.The above differences were statistically significant at Cz,Pz,and Fz(P<0.01);The difference between the latency and amplitude of the upper two groups was the largest(P<0.001).The average Pz latency of delirium patients was 462.23±56.8ms,while the average latency of non-delirium patients was 403.22±23.86ms;the average amplitude of delirium patients was 8.74±2.89?V,instead of The average amplitude of delirium patients was 14.35±4.31?V In all delirium patients,the correlation analysis of the event-related potential P300 at the Pz and delirium ROC curve results showed that:the Pz latency predicted AUC for delirium was 0.800,the sensitivity was 62.9%,and the specificity was 94.4%;the AUC predicted by the Pz amplitude for delirium was 0.805 With a sensitivity of 52.8%and a specificity of 100.0%.Conclusions:1.Event-related potentials can be used as objective indicators to assess delirium;2.In delirium,the event-related potential P300 has a longer latency and shorter amplitude;the latency and amplitude at Pz in P300 may be more sensitive indicators for predicting delirium.