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Association between death and loss of stage N2 sleep features among critically Ill patients with delirium.

Authors :
Knauert MP
Gilmore EJ
Murphy TE
Yaggi HK
Van Ness PH
Han L
Hirsch LJ
Pisani MA
Source :
Journal of critical care [J Crit Care] 2018 Dec; Vol. 48, pp. 124-129. Date of Electronic Publication: 2018 Aug 23.
Publication Year :
2018

Abstract

Purpose: Critically ill patients experience significant sleep disruption. In this study of ICU patients with delirium, we evaluated associations between the loss of stage N2 features (K-complexes, sleep spindles), grade of encephalopathy based on electroencephalography (EEG), and intensive care unit (ICU) outcomes. We hypothesized that loss of stage N2 features is associated with more severe grades of encephalopathy and worse ICU outcomes including death.<br />Materials and Methods: This was an observational cohort study of 93 medical ICU patients without primary acute brain injury who underwent continuous EEG. Type and severity of critical illness, sedative-hypnotic use, length of stay, modified Rankin Scale at hospital discharge, and death during hospitalization were abstracted from the medical record. EEG was evaluated for grade of encephalopathy and sleep features.<br />Results: Patients without K-complexes or without sleep spindles had more severe encephalopathy and higher odds of death. The odds ratio for patients without K-complexes was 18.8 (p = .046). The odds ratio for patients without sleep spindles was 6.3 (p = .036).<br />Conclusions: Loss of stage N2 features is common and associated with more severe encephalopathy and higher odds of death. The absence of either Stage N2 feature, K complexes or sleep spindles, may have important prognostic value.<br /> (Copyright © 2018 Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1557-8615
Volume :
48
Database :
MEDLINE
Journal :
Journal of critical care
Publication Type :
Academic Journal
Accession number :
30179762
Full Text :
https://doi.org/10.1016/j.jcrc.2018.08.028