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1. DeltaScan for the Assessment of Acute Encephalopathy and Delirium in ICU and non-ICU Patients, a Prospective Cross-Sectional Multicenter Validation Study

Author

Ditzel, Fienke L., Hut, Suzanne C.A., van den Boogaard, Mark, Boonstra, Michel, Leijten, Frans S.S., Wils, Evert-Jan, van Nesselrooij, Tim, Kromkamp, Marjan, Rood, Paul J.T., Röder, Christian, Bouvy, Paul F., Coesmans, Michiel, Osse, Robert Jan, Pop-Purceleanu, Monica, van Dellen, Edwin, Krulder, Jaap W.M., Milisen, Koen, Faaij, Richard, Vondeling, Ariël M., Kamper, Ad M., van Munster, Barbara C., de Jonghe, Annemarieke, Winters, Marian A.M., van der Ploeg, Jeanette, van der Zwaag, Sanneke, Koek, Dineke H.L., Drenth-van Maanen, Clara A.C., Beishuizen, Albertus, van den Bos, Deirdre M., Cahn, Wiepke, Schuit, Ewoud, and Slooter, Arjen J.C.

Published
2024
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3. DeltaScan for the Assessment of Acute Encephalopathy and Delirium in ICU and non-ICU Patients, a Prospective Cross-Sectional Multicenter Validation Study

Author

Medische Staf Intensive Care, Onderzoek Brain at Risk, Diagnostiek & Vroege Psychose Medisch, Affectieve & Psychotische Med., Brain, MS Geriatrie, Circulatory Health, Geneeskunde, Onderzoek, Epi Methoden Team 2, Cancer, JC onderzoeksprogramma Methodologie, AIOS Psychiatrie, Ditzel, Fienke L, Hut, Suzanne C A, van den Boogaard, Mark, Boonstra, Michel, Leijten, Frans S S, Wils, Evert-Jan, van Nesselrooij, Tim, Kromkamp, Marjan, Rood, Paul J T, Röder, Christian, Bouvy, Paul F, Coesmans, Michiel, Osse, Robert Jan, Pop-Purceleanu, Monica, van Dellen, Edwin, Krulder, Jaap W M, Milisen, Koen, Faaij, Richard, Vondeling, Ariël M, Kamper, Ad M, van Munster, Barbara C, de Jonghe, Annemarieke, Winters, Marian A M, van der Ploeg, Jeanette, van der Zwaag, Sanneke, Koek, Dineke H L, Drenth-van Maanen, Clara A C, Beishuizen, Albertus, van den Bos, Deirdre M, Cahn, Wiepke, Schuit, Ewoud, Slooter, Arjen J C, Medische Staf Intensive Care, Onderzoek Brain at Risk, Diagnostiek & Vroege Psychose Medisch, Affectieve & Psychotische Med., Brain, MS Geriatrie, Circulatory Health, Geneeskunde, Onderzoek, Epi Methoden Team 2, Cancer, JC onderzoeksprogramma Methodologie, AIOS Psychiatrie, Ditzel, Fienke L, Hut, Suzanne C A, van den Boogaard, Mark, Boonstra, Michel, Leijten, Frans S S, Wils, Evert-Jan, van Nesselrooij, Tim, Kromkamp, Marjan, Rood, Paul J T, Röder, Christian, Bouvy, Paul F, Coesmans, Michiel, Osse, Robert Jan, Pop-Purceleanu, Monica, van Dellen, Edwin, Krulder, Jaap W M, Milisen, Koen, Faaij, Richard, Vondeling, Ariël M, Kamper, Ad M, van Munster, Barbara C, de Jonghe, Annemarieke, Winters, Marian A M, van der Ploeg, Jeanette, van der Zwaag, Sanneke, Koek, Dineke H L, Drenth-van Maanen, Clara A C, Beishuizen, Albertus, van den Bos, Deirdre M, Cahn, Wiepke, Schuit, Ewoud, and Slooter, Arjen J C

Published
2024

4. DeltaScan for the Assessment of Acute Encephalopathy and Delirium in ICU and non-ICU Patients, a Prospective Cross-Sectional Multicenter Validation Study:Fienke L. Ditzel, MD. e-mail: F.l.ditzel@gmail.com

Author

Ditzel, Fienke L., Hut, Suzanne C.A., van den Boogaard, Mark, Boonstra, Michel, Leijten, Frans S.S., Wils, Evert Jan, van Nesselrooij, Tim, Kromkamp, Marjan, Rood, Paul J.T., Röder, Christian, Bouvy, Paul F., Coesmans, Michiel, Osse, Robert Jan, Pop-Purceleanu, Monica, van Dellen, Edwin, Krulder, Jaap W.M., Milisen, Koen, Faaij, Richard, Vondeling, Ariël M., Kamper, Ad M., van Munster, Barbara C., de Jonghe, Annemarieke, Winters, Marian A.M., van der Ploeg, Jeanette, van der Zwaag, Sanneke, Koek, Dineke H.L., Drenth-van Maanen, Clara A.C., Beishuizen, Albertus, van den Bos, Deirdre M., Cahn, Wiepke, Schuit, Ewoud, Slooter, Arjen J.C., Ditzel, Fienke L., Hut, Suzanne C.A., van den Boogaard, Mark, Boonstra, Michel, Leijten, Frans S.S., Wils, Evert Jan, van Nesselrooij, Tim, Kromkamp, Marjan, Rood, Paul J.T., Röder, Christian, Bouvy, Paul F., Coesmans, Michiel, Osse, Robert Jan, Pop-Purceleanu, Monica, van Dellen, Edwin, Krulder, Jaap W.M., Milisen, Koen, Faaij, Richard, Vondeling, Ariël M., Kamper, Ad M., van Munster, Barbara C., de Jonghe, Annemarieke, Winters, Marian A.M., van der Ploeg, Jeanette, van der Zwaag, Sanneke, Koek, Dineke H.L., Drenth-van Maanen, Clara A.C., Beishuizen, Albertus, van den Bos, Deirdre M., Cahn, Wiepke, Schuit, Ewoud, and Slooter, Arjen J.C.

Abstract

Objectives: To measure the diagnostic accuracy of DeltaScan: a portable real-time brain state monitor for identifying delirium, a manifestation of acute encephalopathy (AE) detectable by polymorphic delta activity (PDA) in single-channel electroencephalograms (EEGs). Design: Prospective cross-sectional study. Setting: Six Intensive Care Units (ICU's) and 17 non-ICU departments, including a psychiatric department across 10 Dutch hospitals. Participants: 494 patients, median age 75 (IQR:64-87), 53% male, 46% in ICUs, 29% delirious. Measurements: DeltaScan recorded 4-minute EEGs, using an algorithm to select the first 96 seconds of artifact-free data for PDA detection. This algorithm was trained and calibrated on two independent datasets. Methods: Initial validation of the algorithm for AE involved comparing its output with an expert EEG panel's visual inspection. The primary objective was to assess DeltaScan's accuracy in identifying delirium against a delirium expert panel's consensus. Results: DeltaScan had a 99% success rate, rejecting 6 of the 494 EEG's due to artifacts. Performance showed and an Area Under the Receiver Operating Characteristic Curve (AUC) of 0.86 (95% CI: 0.83-0.90) for AE (sensitivity: 0.75, 95%CI=0.68-0.81, specificity: 0.87 95%CI=0.83-0.91. The AUC was 0.71 for delirium (95%CI=0.66-0.75, sensitivity: 0.61 95%CI=0.52-0.69, specificity: 72, 95%CI=0.67-0.77). Our validation aim was an NPV for delirium above 0.80 which proved to be 0.82 (95%CI: 0.77-0.86). Among 84 non-delirious psychiatric patients, DeltaScan differentiated delirium from other disorders with a 94% (95%CI: 87-98%) specificity. Conclusions: DeltaScan can diagnose AE at bedside and shows a clear relationship with clinical delirium. Further research is required to explore its role in predicting delirium-related outcomes.

Published
2024

5. DeltaScan for the Assessment of Acute Encephalopathy and Delirium in ICU and non-ICU Patients, a Prospective Cross-Sectional Multicenter Validation Study

Author

Ditzel, Fienke L., primary, Hut, Suzanne C.A., additional, van den Boogaard, Mark, additional, Boonstra, Michel, additional, Leijten, Frans S.S., additional, Wils, Evert-Jan, additional, van Nesselrooij, Tim, additional, Kromkamp, Marjan, additional, Rood, Paul J.T., additional, Röder, Christian, additional, Bouvy, Paul F., additional, Coesmans, Michiel, additional, Osse, Robert Jan, additional, Pop-Purceleanu, Monica, additional, van Dellen, Edwin, additional, Krulder, Jaap W.M., additional, Milisen, Koen, additional, Faaij, Richard, additional, Vondeling, Ariël M., additional, Kamper, Ad M., additional, van Munster, Barbara C., additional, de Jonghe, Annemarieke, additional, Winters, Marian A.M., additional, van der Ploeg, Jeanette, additional, van der Zwaag, Sanneke, additional, Koek, Dineke H.L., additional, Drenth-van Maanen, Clara A.C., additional, Beishuizen, Albertus, additional, van den Bos, Deirdre M., additional, Cahn, Wiepke, additional, Schuit, Ewoud, additional, and Slooter, Arjen J.C., additional

Published
2023
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6. Predictors of 1-year drug-related admissions in older multimorbid hospitalized adults

Author

UCL - SSS/LDRI - Louvain Drug Research Institute, UCL - (SLuc) Département de pharmacie, UCL - (MGD) Département de pharmacie, Aubert, Carole E., Rodondi, Nicolas, Netzer, Seraina, Dalleur, Olivia, Spinewine, Anne, Drenth-van Maanen, Clara, Knol, Wilma, O’Mahony, Denis, Aujesky, Drahomir, Donzé, Jacques, UCL - SSS/LDRI - Louvain Drug Research Institute, UCL - (SLuc) Département de pharmacie, UCL - (MGD) Département de pharmacie, Aubert, Carole E., Rodondi, Nicolas, Netzer, Seraina, Dalleur, Olivia, Spinewine, Anne, Drenth-van Maanen, Clara, Knol, Wilma, O’Mahony, Denis, Aujesky, Drahomir, and Donzé, Jacques

Abstract

Background Identifying patients at high risk of drug-related hospital admission (DRA) may help to efficiently target preventive interventions. We developed a score to predict DRAs in older patients with multimorbidity and polypharmacy. Methods We used participants from the multicenter European OPERAM trial (“Optimising PharmacothERapy in the Mutlimorbid Elderly”). We assessed the association between easily identifiable a priori predictors and 1-year DRAs by univariable logistic regression. Variables with p<0.20 were taken forward to backward regression. We retained all variables with p<0.05 in the model. We assessed the C-statistic, calibration (observed/predicted proportions), and overall accuracy (scaled Brier score, <0.25 indicating a useful model) of the score, and internally validated it by tenfold cross-validation. Results Within 1 year, 435/1,879 (23.2%) patients (mean age 79.4 years) had a DRA. The score included 7 variables: previous hospitalizations, non-elective admission, hypertension, cirrhosis with portal hypertension, chronic kidney disease, diuretic, corticosteroid. The C-statistic was 0.64 (95% CI 0.61-0.67). Patients with <1 point had a 12.4% predicted and observed risk of DRA, while those with >3 points had a 40.4% predicted and 38.9% observed risk of DRA. Scaled Brier score was 0.05. Calibration showed adequate match between predicted and observed proportions. Conclusion Comorbidities related to drug metabolism, specific medications, non-elective admission, and a history of hospitalization, were associated with a higher risk of DRA. Awareness of these associations and the score we developed may help identifying short before discharge patients most likely to benefit from preventive interventions.

Published
2022

8. Teaching geriatric medicine through gamification: a tool for enhancing postgraduate education in geriatric medicine

Author

Schlögl, Mathias, primary, Roller-Wirnsberger, Regina Elisabeth, additional, Hernes, Susanne Sørensen, additional, Perkisas, Stany, additional, Bakken, Marit Stordal, additional, Miot, Stéphanie, additional, Balci, Cafer, additional, Dani, Melanie, additional, Pajulammi, Hanna, additional, Piaggi, Paolo, additional, Drenth-van Maanen, Clara, additional, and Singler, Katrin, additional

Published
2021
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16. Adherence with dosing guideline in patients with impaired renal function at hospital discharge

Author

MS Geriatrie, Apotheek Klinische Farmacie, Centraal Diagnostisch Laboratorium, Apotheek, Drenth-van Maanen, Clara, Van Marum, Rob J., Jansen, Paul A F, Zwart-van Rijkom, JEF, Van Solinge, Wouter W., Egberts, Toine C G, MS Geriatrie, Apotheek Klinische Farmacie, Centraal Diagnostisch Laboratorium, Apotheek, Drenth-van Maanen, Clara, Van Marum, Rob J., Jansen, Paul A F, Zwart-van Rijkom, JEF, Van Solinge, Wouter W., and Egberts, Toine C G

Published
2015

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