s (≥18 years) receiving general anesthesia between January 2016 and December 2018 were analyzed. Risk factors for burst suppression were evaluated using univariate and multivariable analysis. We measured the incidence of burst suppression as indicated by the burst suppression ratio (BSR) of the Entropy Module, the maximum and mean BSR values, relative burst suppression duration, mean volatile anesthetic concentrations, and mean age-adjusted minimum alveolar concentrations (aaMAC) at burst suppression, and cases of potentially misclassified burst suppression episodes. Analyses were done separately for the total anesthesia period, as well as for the Induction and Maintenance phase. The association with age was evaluated using linear and polynomial fits and by calculating correlation coefficients. RESULTS: Of the 54,266 patients analyzed, 38,628 were included, and 19,079 patients exhibited episodes with BSR >0. Patients with BSR >0 were significantly older, and age had the highest predictive power for BSR >0 (area under the receiving operating characteristic [AUROC] = 0.646 [0.638–0.654]) compared to other patient or procedural factors. The probability of BSR >0 increased linearly with patient age (ρ = 0.96–0.99) between 1.9% and 9.8% per year. While maximal and mean BSR showed a nonlinear relationship with age, relative burst suppression duration also increased linearly during maintenance (ρ = 0.83). Further, episodes potentially indicating burst suppression that were not detected by the Entropy BSR algorithm also became more frequent with age. Volatile anesthetic concentrations sufficient to induce BSR >0 were negatively correlated with age (sevoflurane: ρ = −0.71), but remained close to an aaMAC of 1.0. CONCLUSIONS: The probability of burst suppression during general anesthesia increases linearly with age in adult patients, while lower anesthetic concentrations induce burst suppression with increasing patient age. Simultaneously, algorithm-based burst suppression detection appears to perform worse in older patients. These findings highlight the necessity to further enhance EEG application and surveillance strategies in anesthesia....

中文翻译：

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年龄对处理性脑电图突发抑制发生的影响


分析 2016 年 1 月至 2018 年 12 月期间接受全身麻醉的 （≥18 岁）。使用单变量和多变量分析评估突发抑制的危险因素。我们测量了熵模块的突发抑制率 （BSR） 指示的突发抑制发生率、最大和平均 BSR 值、相对突发抑制持续时间、平均挥发性麻醉剂浓度和平均年龄调整后的最低肺泡浓度 （aaMAC） 在突发抑制时，以及可能错误分类的突发抑制事件的情况。分别对总麻醉期以及诱导和维持期进行分析。使用线性和多项式拟合以及计算相关系数来评估与年龄的相关性。结果： 在分析的 54,266 例患者中，包括 38,628 例，19,079 例患者表现出 BSR >0 发作。BSR >0 患者年龄显著升高，与其他患者或手术因素相比，年龄对 BSR >0 （接受工作特征下的面积 [AUROC] = 0.646 [0.638–0.654]）的预测能力最高。BSR >0 的概率随患者年龄 （ρ = 0.96–0.99） 线性增加，每年在 1.9% 至 9.8% 之间。虽然最大和平均 BSR 与年龄呈非线性关系，但在维护期间，相对突发抑制持续时间也呈线性增加 （ρ = 0.83）。此外，熵 BSR 算法未检测到的可能表明突发抑制的情节也随着年龄的增长而变得更加频繁。足以诱导 BSR >0 的挥发性麻醉剂浓度与年龄呈负相关（七氟烷：ρ = -0.71），但仍接近 aaMAC 1.0。 结论： 成年患者全身麻醉期间爆发抑制的可能性随年龄增长线性增加，而较低的麻醉剂浓度随着患者年龄的增长而诱导爆发抑制。同时，基于算法的突发抑制检测在老年患者中的表现似乎更差。这些发现强调了进一步加强脑电图应用和麻醉监测策略的必要性。