응급실에 내원한 진정제 중독환자에서 BIS (Bispectral Index Score)의 유용성 (The Utility of Bispectral Index Scores for Sedative Intoxication in the Emergency Department)

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 21권 / 5호 / 628 ~ 636페이지
· 저자명 : 성현경, 홍성엽, 양영모, 박경남, 양희범, 박정규, 이화연, 이장영

초록

Purpose: This study was designed to determine the utility of bispectral index scores (BIS) compared to Glasgow coma scale (GCS) or Observer’s Assessment of Alertness/Sedation Scale (OAA/S), in measuring changes in consciousness,prognosis and management of sedative-intoxication patients.
Methods: Sedative intoxication patients, who came to the emergency department with a severe deficit in consciousness,or a GCS less than 12, were analyzed. Patients’ consciousness states were evaluated using OAA/S and GCS and compared with BIS scores. Patients’ consciousness recovery time and hospitalization were recorded to see if these could be predicted by BIS using regression analysis.
BIS, OAS/S and GCS were compared with regard to intubation,admission and ICU admission. Furthermore, usefulness and cut-off values of BIS were evaluated for those intubated.
Results: Of 128 sedative intoxication patients, 32 were enrolled for this study. Mean age was 50.94±18.01. They took 20.76±16.95 times the average recommended dose.
OAA/S and GCS ranged between 1~4 and 4~12, respectively;BIS was 39~88. The Spearman bivariate correlation coefficient was 0.619 between OAA/S and BIS and 0.651between GCS and BIS, both showing a positive correlation (p<0.001). The coefficient of determination between BIS and recovery time was 0.182 and was statistically significant (Recovery time = -0.321×BIS+34.806) (p=0.015).
However, admission, ICU admission and hospitalization were not significant (p>0.05). BIS was an effective index for intubation (p=0.012) showing a sensitivity of 91% and a specificity of 50% when the boundary value was set to 65.5.
When set to 77.5, sensitivity and specificity were 59%,100%, respectively.
Conclusion: In sedative intoxication patients, BIS is useful in determining the degree of sedation, predicting time to recovery of consciousness and as an objective index of intubation.

영어초록

Purpose: This study was designed to determine the utility of bispectral index scores (BIS) compared to Glasgow coma scale (GCS) or Observer’s Assessment of Alertness/Sedation Scale (OAA/S), in measuring changes in consciousness,prognosis and management of sedative-intoxication patients.
Methods: Sedative intoxication patients, who came to the emergency department with a severe deficit in consciousness,or a GCS less than 12, were analyzed. Patients’ consciousness states were evaluated using OAA/S and GCS and compared with BIS scores. Patients’ consciousness recovery time and hospitalization were recorded to see if these could be predicted by BIS using regression analysis.
BIS, OAS/S and GCS were compared with regard to intubation,admission and ICU admission. Furthermore, usefulness and cut-off values of BIS were evaluated for those intubated.
Results: Of 128 sedative intoxication patients, 32 were enrolled for this study. Mean age was 50.94±18.01. They took 20.76±16.95 times the average recommended dose.
OAA/S and GCS ranged between 1~4 and 4~12, respectively;BIS was 39~88. The Spearman bivariate correlation coefficient was 0.619 between OAA/S and BIS and 0.651between GCS and BIS, both showing a positive correlation (p<0.001). The coefficient of determination between BIS and recovery time was 0.182 and was statistically significant (Recovery time = -0.321×BIS+34.806) (p=0.015).
However, admission, ICU admission and hospitalization were not significant (p>0.05). BIS was an effective index for intubation (p=0.012) showing a sensitivity of 91% and a specificity of 50% when the boundary value was set to 65.5.
When set to 77.5, sensitivity and specificity were 59%,100%, respectively.
Conclusion: In sedative intoxication patients, BIS is useful in determining the degree of sedation, predicting time to recovery of consciousness and as an objective index of intubation.

참고자료

· 없음