@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. 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",
}