Perioperative medicine & outcomes
Association of Altered Anteriorization of Electroencephalographic Alpha Oscillation During Transition to Unconsciousness With Postoperative Delirium: A Prospective Observational Study
Authors' conclusion
Delirium was associated with early disruption of alpha anteriorization during induction and globally reduced functional network efficiency during maintenance. Perioperative electroencephalogram (EEG) transition features may serve as early markers of delirium susceptibility.
Study context
- Population
- Elderly patients under sevoflurane-induced anesthesiaenrolled, 83 with electroencephalography data after excluding 17 due to artifacts
- Participants
- 100 participants
- Exposure
- Nondelirium vs delirium groups
- Nondeliriumn = 81
- Deliriumn = 19
- Outcome
- Alpha power amplification just before the loss of responsiveness, frontal (median [IQR], dB)
- Follow-up
- Just before loss of responsiveness
Methodological detailssingle tertiary university hospital
- Single tertiary university hospital
Main finding
As reported in the abstract
Nondelirium
4.24
median · IQR 1.86–6.57 · dB
Delirium
−0.88
median · IQR −1.59–3.38 · dB
P = 0.007
Observational data: associations, not effects.
Further findings
Alpha power during maintenance, frontal (dB) · Maintenance phase
P = 0.007
| Outcome | Nondelirium | Delirium | P value |
|---|---|---|---|
| Alpha power amplification just before the loss of responsiveness, parietal (median [IQR], dB) | median 3.71 (IQR 0.51–5.55) dB | median −0.95 (IQR −2.33–1.11) dB | P = 0.046 |
| Alpha power amplification just before the loss of responsiveness, occipital (median [IQR], dB) | median 2.81 (IQR 0.49–5.71) dB | median −0.04 (IQR −2.06–1.27) dB | P = 0.048 |
| Averaged characteristic path length (network analysis) · Maintenance phaseLonger in the delirium group · FDR-corrected · mean | 3.57 (SD 0.16) | 4.49 (SD 0.62) | P = 0.026, FDR-corrected |
- Alpha power during maintenance, frontal (dB): higher alpha power in the nondelirium group across all 19 channels
Alpha power during maintenance, frontal (dB) · Maintenance phase
- Alpha power during maintenance, frontal (dB) — nondelirium vs delirium: 5.42 [2.90-8.16] vs 2.89 [−0.03-5.09], P = .007; higher in the nondelirium group across all 19 channels, 18 of 19 significant by false-discovery-rate (FDR)-corrected permutation test
Averaged characteristic path length (network analysis) · Maintenance phase
- Consistently longer in the frontal, parietal, and occipital regions, suggesting reduced network efficiency
Original publication
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