Increased mortality in patients with standard EEG findings of 'diffuse slowing'.

BACKGROUND: We aimed to confirm the association between slow brain wave activity typically described as "diffuse slowing" on standard electroencephalogram (EEG) and patient outcomes, including mortality. METHODS: This retrospective study was conducted with patient chart data from March 2015 to March 2017 at a tertiary care academic hospital in the midwestern United States. In total, 1,069 participants age ≥55 years on an inpatient floor or ICU received a standard 24-hour EEG. The primary outcome was all-cause mortality at 30, 90, 180, and 365 days. Secondary outcomes were time to discharge, and discharge to home. RESULTS: Having diffuse slowing on standard EEG was significantly associated with 30-, 90-, 180-, and 365-day mortality compared with patients who had normal EEG findings, after controlling for age, sex, and Charlson Comorbidity Index score. When controlling for these factors, patients with diffuse slowing had a significantly longer time to discharge and were significantly less likely to discharge to home. Our findings showed that a standard EEG finding of diffuse slowing for inpatients age ≥55 years is associated with poor outcomes, including greater mortality. CONCLUSIONS: This study suggested that the finding of diffuse slowing on EEG may be an important clinical marker for predicting mortality in geriatric inpatients.

Increased mortality in patients with standard EEG findings of 'diffuse slowing'.

BACKGROUND: We aimed to confirm the association between slow brain wave activity typically described as "diffuse slowing" on standard electroencephalogram (EEG) and patient outcomes, including mortality. METHODS: This retrospective study was conducted with patient chart data from March 2015 to March 2017 at a tertiary care academic hospital in the midwestern United States. In total, 1,069 participants age ≥55 years on an inpatient floor or ICU received a standard 24-hour EEG. The primary outcome was all-cause mortality at 30, 90, 180, and 365 days. Secondary outcomes were time to discharge, and discharge to home. RESULTS: Having diffuse slowing on standard EEG was significantly associated with 30-, 90-, 180-, and 365-day mortality compared with patients who had normal EEG findings, after controlling for age, sex, and Charlson Comorbidity Index score. When controlling for these factors, patients with diffuse slowing had a significant longer time to discharge and were significantly less likely to discharge to home. Our findings showed that a standard EEG finding of diffuse slowing for inpatients age ≥55 years is associated with poor outcomes, including greater mortality. CONCLUSIONS: This study suggested that the finding of diffuse slowing on EEG may be an important clinical marker for predicting mortality in geriatric inpatients.

Genome-wide DNA methylation investigation of glucocorticoid exposure within buccal samples.

AIM: Glucocorticoids play a major role in regulating the stress response, and an imbalance of glucocorticoids has been implicated in stress-related disorders. Within mouse models, CpGs across the genome have been shown to be differentially methylated in response to glucocorticoid treatment, and using the Infinium 27K array, it was shown that humans given synthetic glucocorticoids had DNA methylation (DNAm) changes in blood. However, further investigation of the extent to which glucocorticoids affect DNAm across a larger proportion of the genome is needed. METHODS: Buccal samples were collected before and after synthetic glucocorticoid treatment in the context of a dental procedure. This included 30 tooth extraction surgery patients who received 10 mg of dexamethasone. Genome-wide DNAm was assessed with the Infinium HumanMethylationEPIC array. RESULTS: Five CpGs showed genome-wide significant DNAm changes that were >10%. These differentially methylated CpGs were in or nearest the following genes: ZNF438, KLHDC10, miR-544 or CRABP1, DPH5, and WDFY2. Using previously published datasets of human blood gene expression changes following dexamethasone exposure, a significant proportion of genes with false-discovery-rate-adjusted significant CpGs were also differentially expressed. A pathway analysis of the genes with false-discovery-rate-adjusted significant CpGs revealed significant enrichment of olfactory transduction, pentose and glucuronate interconversions, ascorbate and aldarate metabolism, and steroid hormone biosynthesis pathways. CONCLUSION: High-dose synthetic glucocorticoid administration in the setting of a dental procedure was significantly associated with DNAm changes within buccal samples. These findings are consistent with prior findings of an influence of glucocorticoids on DNAm in humans.