{
    "abstract": "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.\nThis 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.\nOf 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).\nAn 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.\nNCT02241655.",
    "authors": [
        {
            "affiliation": "Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA. Electronic address: bafritz@wustl.edu.",
            "firstname": "Bradley A",
            "initials": "BA",
            "lastname": "Fritz"
        },
        {
            "affiliation": "Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.",
            "firstname": "Christopher R",
            "initials": "CR",
            "lastname": "King"
        },
        {
            "affiliation": "Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.",
            "firstname": "Angela M",
            "initials": "AM",
            "lastname": "Mickle"
        },
        {
            "affiliation": "Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.",
            "firstname": "Troy S",
            "initials": "TS",
            "lastname": "Wildes"
        },
        {
            "affiliation": "Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.",
            "firstname": "Thaddeus P",
            "initials": "TP",
            "lastname": "Budelier"
        },
        {
            "affiliation": "Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.",
            "firstname": "Jordan",
            "initials": "J",
            "lastname": "Oberhaus"
        },
        {
            "affiliation": "Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.",
            "firstname": "Daniel",
            "initials": "D",
            "lastname": "Park"
        },
        {
            "affiliation": "Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.",
            "firstname": "Hannah R",
            "initials": "HR",
            "lastname": "Maybrier"
        },
        {
            "affiliation": "Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.",
            "firstname": "Arbi",
            "initials": "A",
            "lastname": "Ben Abdallah"
        },
        {
            "affiliation": "Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.",
            "firstname": "Alex",
            "initials": "A",
            "lastname": "Kronzer"
        },
        {
            "affiliation": "Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.",
            "firstname": "Sherry L",
            "initials": "SL",
            "lastname": "McKinnon"
        },
        {
            "affiliation": "Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.",
            "firstname": "Brian A",
            "initials": "BA",
            "lastname": "Torres"
        },
        {
            "affiliation": "Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.",
            "firstname": "Thomas J",
            "initials": "TJ",
            "lastname": "Graetz"
        },
        {
            "affiliation": "Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.",
            "firstname": "Daniel A",
            "initials": "DA",
            "lastname": "Emmert"
        },
        {
            "affiliation": "Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.",
            "firstname": "Ben J",
            "initials": "BJ",
            "lastname": "Palanca"
        },
        {
            "affiliation": "Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.",
            "firstname": "Tracey W",
            "initials": "TW",
            "lastname": "Stevens"
        },
        {
            "affiliation": "Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.",
            "firstname": "Susan L",
            "initials": "SL",
            "lastname": "Stark"
        },
        {
            "affiliation": "Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.",
            "firstname": "Eric J",
            "initials": "EJ",
            "lastname": "Lenze"
        },
        {
            "affiliation": "Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.",
            "firstname": "Michael S",
            "initials": "MS",
            "lastname": "Avidan"
        },
        {
            "affiliation": null,
            "firstname": null,
            "initials": null,
            "lastname": null
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2021 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.",
    "doi": "10.1016/j.bja.2021.04.036",
    "journal": "British journal of anaesthesia",
    "keywords": [
        "burst suppression",
        "depth of anaesthesia",
        "electroencephalogram suppression",
        "postoperative death",
        "postoperative delirium",
        "postoperative falls",
        "postoperative mortality",
        "quality of life"
    ],
    "methods": null,
    "publication_date": "2021-07-11",
    "pubmed_id": "34243940\n27799174\n15616043\n24852500\n28361391\n25928189\n26418126\n20664045\n23027226\n30721296\n31645286\n23539236\n23539235\n20332509\n19001484\n27311914\n2240918\n11445689\n15673358\n24733193\n28263192\n19051059\n16137297\n18591202\n30980045\n20418692\n21293252\n5662937\n26889483\n15172773\n18337600\n21848460\n19910621\n30090923\n30857604\n30857598\n19106695\n24890941\n28486575",
    "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).",
    "title": "Effect of electroencephalogram-guided anaesthesia administration on 1-yr mortality: follow-up of a randomised clinical trial.",
    "xml": "<Element 'PubmedArticle' at 0x788503d9b650>"
}