@article{e4c105918b60424eb7fb0aa5a6901927,
title = "Effect of electroencephalogram-guided anaesthesia administration on 1-yr mortality: follow-up of a randomised clinical trial",
abstract = "Background: Intraoperative EEG suppression duration has been associated with postoperative delirium and mortality. In a clinical trial testing anaesthesia titration to avoid EEG suppression, the intervention did not decrease the incidence of postoperative delirium, but was associated with reduced 30-day mortality. The present study evaluated whether the EEG-guided anaesthesia intervention was also associated with reduced 1-yr mortality. Methods: This manuscript reports 1 yr follow-up of subjects from a single-centre RCT, including a post hoc secondary outcome (1-yr mortality) in addition to pre-specified secondary outcomes. The trial included subjects aged 60 yr or older undergoing surgery with general anaesthesia between January 2015 and May 2018. Patients were randomised to receive EEG-guided anaesthesia or usual care. The previously reported primary outcome was postoperative delirium. The outcome of the current study was all-cause 1-yr mortality. Results: Of the 1232 subjects enrolled, 614 subjects were randomised to EEG-guided anaesthesia and 618 subjects to usual care. One-year mortality was 57/591 (9.6%) in the guided group and 62/601 (10.3%) in the usual-care group. No significant difference in mortality was observed (adjusted absolute risk difference, –0.7%; 99.5% confidence interval, –5.8% to 4.3%; P=0.68). Conclusions: An EEG-guided anaesthesia intervention aiming to decrease duration of EEG suppression during surgery did not significantly decrease 1-yr mortality. These findings, in the context of other studies, do not provide supportive evidence for EEG-guided anaesthesia to prevent intermediate term postoperative death. Clinical trial registration: NCT02241655.",
keywords = "burst suppression, depth of anaesthesia, electroencephalogram suppression, postoperative death, postoperative delirium, postoperative falls, postoperative mortality, quality of life",
author = "{ENGAGES Research Group} and Fritz, {Bradley A.} and King, {Christopher R.} and Mickle, {Angela M.} and Wildes, {Troy S.} and Budelier, {Thaddeus P.} and Jordan Oberhaus and Daniel Park and Maybrier, {Hannah R.} and {Ben Abdallah}, Arbi and Alex Kronzer and McKinnon, {Sherry L.} and Torres, {Brian A.} and Graetz, {Thomas J.} and Emmert, {Daniel A.} and Palanca, {Ben J.} and Stevens, {Tracey W.} and Stark, {Susan L.} and Lenze, {Eric J.} and Avidan, {Michael S.} and Abdallah, {Arbi B.} and Ginika Apakama and Amrita Aranake-Chrisinger and Jacob Bolzenius and Jamila Burton and Victoria Cui and Shreya Goswami and Shelly Gupta and Katherine Jordan and Muench, {Maxwell R.} and Murphy, {Matthew R.} and Aamil Patel and Spencer, {James W.} and Patricia Strutz and Tedeschi, {Catherine M.} and Trammel, {Emma R.} and Upadhyayula, {Ravi T.} and Winter, {Anke C.} and Nan Lin and Eric Jacobsohn and Tamara Fong and Jackie Gallagher and Inouye, {Sharon K.} and Schmitt, {Eva M.} and Emily Somerville and Susan Stark and Melby, {Spencer J.} and Jennifer Tappenden",
note = "Funding Information: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: all authors had financial support from the National Institutes of Health for the submitted work; SLS reported grants from the National Institutes of Health, the National Institute of Disability, Independent Living and Rehabilitation Research, and the Department of Housing and Urban Development; EJL reported grants from PCORI, Takeda, the McKnight Brain Research Foundation, the Taylor Family Institute, the Barnes-Jewish Foundation, Lundbeck, Janssen Pharmaceuticals, Alkermes, Aptinyx Inc., and the US Food and Drug Administration; the other authors reported no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 yr; no other relationships or activities that could appear to have influenced the submitted work.US National Institute on Aging (grant number UH3 AG050312). US National Institute for General Medical Sciences (grant number T32 GM108539). Funding Information: National Institute on Aging (grant number UH3 AG050312 ). National Institute for General Medical Sciences (grant number T32 GM108539 ). Publisher Copyright: {\textcopyright} 2021 British Journal of Anaesthesia",
year = "2021",
month = sep,
doi = "10.1016/j.bja.2021.04.036",
language = "English",
volume = "127",
pages = "386--395",
journal = "British Journal of Anaesthesia",
issn = "0007-0912",
number = "3",
}