Evidence map›Paper›PMID 32466776›Full record

Trial reportBMC anesthesiology2020

Effect of baseline cognitive impairment on association between predicted propofol effect site concentration and Bispectral index or sedation score.

Frederick Sieber, Karin Neufeld, Esther S Oh, Allan Gottschalk, Nae-Yuh Wang

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC anesthesiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact, top 93% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 1 country.

Frederick SieberDepartment of Anesthesiology and Critical Care Medicine, Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Baltimore, MD, 21224, USA. fsieber1@jhmi.edu.
Karin NeufeldDepartment of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, A4Center Suite 457, 4940 Eastern Ave, Baltimore, USA.
Esther S OhDivision of Geriatric Medicine and Gerontology, Psychiatry and Behavioral Sciences & Neuropathology, Johns Hopkins University School of Medicine, Mason F. Lord Building, Center Tower, 5200 Eastern Avenue, 7th Floor, Baltimore, MD, 21224, USA.
Allan GottschalkDepartments of Anesthesiology and Critical Care Medicine and Neurosurgery, Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD, 21287, USA.
Nae-Yuh WangMedicine, Biostatistics and Epidemiology, The Johns Hopkins University, 2024 E. Monument Street, Suite 2-500, Baltimore, MD, 21287, USA.
Johns Hopkins University · USBehavioral Pharma (United States) · USJohns Hopkins Bayview Medical Center · USJohns Hopkins Hospital · US

Funding

A Strategy for Reduction of Postoperative Delirium in Elderly PatientsR01AG033615 · NIA · JOHNS HOPKINS UNIVERSITY · PI SIEBER, FREDERICK E · 2010 to 2014
$2.0M
NIA NIH HHS R01 AG033615
6 · The paper itself

Abstract

backgroundThis study determined whether the relationship between predicted propofol effect site concentration (Ce) and observer's assessment of alertness/sedation scale (OAA/S) or Bispectral Index (BIS) was similar comparing cognitively intact vs impaired patients undergoing hip fracture repair with spinal anesthesia and sedation.

methodsFollowing informed consent baseline mini-mental status exam (MMSE), Clinical Dementia Rating (CDR) and geriatric depression scale (GDS) were obtained. Intraoperatively OAA/S, BIS, and propofol (timing and exact amounts) administered were recorded. Cerebrospinal fluid was collected for Alzheimer's (AD) biomarkers. Mean Ce level (AvgCe) during surgery was calculated using the area under the Ce measurement series from incision to closure, divided by surgical time. Average OAA/S (AvgOAA/S), and BIS (AvgBIS) were similarly calculated. Pearson correlations of AvgCe with AvgOAA/S and AvgBIS were calculated overall and by CDR. Nonparametric locally weighted scatterplot smoothing (LOWESS) fits of AvgOAA/S and AvgBIS on AvgCe were produced, stratified by CDR. Multivariable regression incorporating baseline cognitive measurements or AD biomarkers assessed AvgOAA/S or AvgBIS associations with AvgCe.

resultsIn 186 participants AvgBIS and AvgOAA/S correlated with AvgCe (Pearson ρ = - 0.72; p < 0.0001 and Pearson ρ = - 0.81; p < 0.0001, respectively), and remained unchanged across CDR levels. Association patterns of AvgOAA/S or AvgBIS on AvgCe guided by LOWESS fits and modeled through regression, were similar when stratified by CDR (p = 0.16). Multivariable modeling found no independent effect on AvgBIS or AvgOAA/S by MMSE, CDR, GDS, or AD biomarkers after accounting for AvgCe.

conclusionsWhen administering sedation in conjunction with spinal anesthesia, cognitive impairment does not affect the relationship between predicted propofol AvgCe and AvgOAA/S or AvgBIS.

Indexed as

Consciousness MonitorsAgedAged, 80 and overCognitive DysfunctionHip FracturesHumansHypnotics and SedativesProcedural SedationPropofolHypnotics and SedativesPropofolBispectral indexCognitive dysfunctionConscious sedationDeep sedationGeriatric anesthesiaHip fracturesobserver’s assessment of alertness and sedation (OAA/S)Propofol

Identifiers

PMID32466776
PMCPMC7254641
OpenAlexW3031676107

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.