DOI
https://doi.org/10.25772/SCQA-VY76
Defense Date
2021
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Health Related Sciences
First Advisor
T. Corey Davis, PhD, CRNA
Second Advisor
Chuck Biddle, PhD, CRNA
Third Advisor
Tyler Corson, PhD
Fourth Advisor
Ernie Steidle, PhD
Fifth Advisor
Patricia Slattum, PhD, PharmD
Sixth Advisor
Shilen Thakrar, MD
Abstract
Postoperative delirium (POD) is a public health and research priority (American Society of Anesthesiologists, 2019). POD is a risk factor for long-term neurocognitive decline, and the rate of decline is directly proportional to the severity of POD (Vasunilashorn et al., 2018). Baseline cognitive function is a strong, independent predictor for POD (Culley et al., 2017). The International Perioperative Neurotoxicity Working Group recommends baseline cognitive function be assessed for older patients prior to surgery and anesthesia (Berger, et al., 2018). Perioperative cognitive screening tools trialed in anesthesia are not routinely incorporated into clinical practice related to validity, reliability, or practicality problems (Berger, et al., 2018). The ideal perioperative cognitive screening tool would be rapid, easily-administrable, valid, reliable, automatically scored, void of language, cultural, and education bias and cost-efficient (Axley & Schenning, 2015). No such tool has been identified to date. This study, guided by Donabedian’s theoretical model, evaluated the utility of a novel point-of-care (POC) electroencephalography (EEG) system, WAVi MedicalTM (Boulder, CO), for the perioperative neurocognitive assessment of older surgical patients. This study conducted a secondary analysis of data from the “Perioperative Brain Health” – IRB HM20019839 study. The “Perioperative Brain Health” study is an ongoing study collecting both pre- and postoperative questionnaire-based neurocognitive assessments alongside WAVi-derived P300 auditory evoked potentials. Data was analyzed using regression and analysis of variance. The WAVi MedicalTM system may one day offer anesthesia providers a novel neurocognitive assessment tool for predicting, identifying, and tracking perioperative neurocognitive disorders in older surgical patients.
Rights
© L. Harold Barnwell, III, PhD, DNAP, CRNA
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
12-6-2021