Development and Evaluation of a Method for Automated Detection of Spreading Depolarizations in the Injured Human Brain.
Development and Evaluation of a Method for Automated Detection of Spreading Depolarizations in the Injured Human Brain.
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DOI：
10.1007/s12028-021-01228-x
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发表时间：
2021-10
影响因子：
3.5
通讯作者：
Strong AJ
中科院分区：
文献类型：
--
作者：
Jewell S;Hobson S;Brewer G;Rogers M;Hartings JA;Foreman B;Lavrador JP;Sole M;Pahl C;Boutelle MG;Strong AJ
在重型颅脑损伤后接受重症监护的患者中，约60%会发生弥漫性去极化(SD)，并且在严重蛛网膜下腔出血和恶性半球卒中(MHS)后发生率较高；它们独立地与较差的临床结局相关。正如现在所倡导的那样，检测SDS以指导临床治疗，目前需要对皮层脑电(ECoG)进行连续和熟练的监测，通常持续很多天。我们在两个临床重症监护病房(ICU)开发和评估了一个软件程序，该程序能够在床边实时和回顾性地检测抑郁，并能够显示其随时间发生的模式。我们在来自18名患者的91个数据文件中测试了这个原型软件，每个文件大约24小时，并将结果与由经验丰富的评估员在不了解软件输出的情况下进行的手动评估结果进行比较。该软件成功地在床边实时检测到了抑郁症，包括患有抑郁症聚集性的患者。调查人员(独立)用软件(因变量)计算的抑郁自评量(因变量)与真实情况进行线性回归比较。回归的斜率为0.7855(95%可信区间0.7149-0.8561)；斜率值1.0位于斜率的95%可信区间之外，表示显著低于79%的敏感度。R2为0.8415。尽管敏感度显著不足，但在高SD计数时没有额外的敏感度损失，从而确保特定致病潜力的密集去极化簇可以通过软件检测并实时向临床医生描述，也可以存档。网上版载有补充材料，可在10.1007/s12028-021-01228-x查阅。
Spreading depolarizations (SDs) occur in some 60% of patients receiving intensive care following severe traumatic brain injury and often occur at a higher incidence following serious subarachnoid hemorrhage and malignant hemisphere stroke (MHS); they are independently associated with worse clinical outcome. Detection of SDs to guide clinical management, as is now being advocated, currently requires continuous and skilled monitoring of the electrocorticogram (ECoG), frequently extending over many days. We developed and evaluated in two clinical intensive care units (ICU) a software routine capable of detecting SDs both in real time at the bedside and retrospectively and also capable of displaying patterns of their occurrence with time. We tested this prototype software in 91 data files, each of approximately 24 h, from 18 patients, and the results were compared with those of manual assessment (“ground truth”) by an experienced assessor blind to the software outputs. The software successfully detected SDs in real time at the bedside, including in patients with clusters of SDs. Counts of SDs by software (dependent variable) were compared with ground truth by the investigator (independent) using linear regression. The slope of the regression was 0.7855 (95% confidence interval 0.7149–0.8561); a slope value of 1.0 lies outside the 95% confidence interval of the slope, representing significant undersensitivity of 79%. R2 was 0.8415. Despite significant undersensitivity, there was no additional loss of sensitivity at high SD counts, thus ensuring that dense clusters of depolarizations of particular pathogenic potential can be detected by software and depicted to clinicians in real time and also be archived. The online version contains supplementary material available at 10.1007/s12028-021-01228-x.
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影响因子：
14.5
作者：
Dreier, Jens P.;Woitzik, Johannes;Strong, Anthony J.
通讯作者：
Strong, Anthony J.
影响因子：
6.3
作者：
Shin, Hwa Kyoung;Dunn, Andrew K.;Ayata, Cenk
通讯作者：
Ayata, Cenk
DOI：
10.1093/brain/awp102
发表时间：
2009-07
期刊：
Brain : a journal of neurology
影响因子：
--
作者：
Dreier JP;Major S;Manning A;Woitzik J;Drenckhahn C;Steinbrink J;Tolias C;Oliveira-Ferreira AI;Fabricius M;Hartings JA;Vajkoczy P;Lauritzen M;Dirnagl U;Bohner G;Strong AJ;COSBID study group
通讯作者：
COSBID study group
影响因子：
3.5
作者：
Helbok, Raimund;Hartings, Jed A.;Carlson, Andrew
通讯作者：
Carlson, Andrew
影响因子：
3.5
作者：
Shuttleworth, C. William;Andrew, R. David;Hartings, Jed A.
通讯作者：
Hartings, Jed A.