Perioperative medicine & outcomes
The Value of the Aperiodic Exponent of the Intraoperative Electroencephalogram for Predicting Postoperative Delirium in Elderly Patients
Primary result · Aperiodic exponentResult — go to the resultOdds ratio 23.2 CI 2.1–318.2Authors' conclusion
A higher aperiodic exponent, for example, a less complex EEG signal, is associated with a greater POD risk, especially in combination with known POD predictors such as age and duration of surgery.
Study context
- Population
- Patients aged ≥60 years undergoing major cardiac or non-cardiac surgery120 training, 60 validation
- Comparison
- Postoperative delirium (POD) vs no POD
- PODn = 32
- Primary endpoint
- Prediction of POD by periodic and aperiodic EEG power-spectrum parameters
Methodological detailstraining and validation cohorts (2:1)
- Training and validation cohorts (2:1)
Primary result
Aperiodic exponent
Odds ratio
23.2
CI 2.1–318.2
P = 0.013
By group
POD
2.09
mean · SD 0.19
Aperiodic exponent
OR 23.2 (CI 2.1–318.2); P = 0.013
As reported in the abstract
- Sensitivity for POD at cutoff 1.967
- 0.813
- Specificity for POD at cutoff 1.967
- 0.478
Further findings
Duration of surgery
| OR (95% CI) | P value | ||
|---|---|---|---|
| Duration of surgeryUnivariable logistic regression | 1.01 (1.00–1.01) | P = 0.005 | |
| 0.512Odds ratio (log scale) |
Peak center frequency
| OR (CI) | P value | ||
|---|---|---|---|
| Peak center frequencyUnivariable logistic regression | 0.79 (0.62–0.97) | P = 0.039 | |
| 0.512Odds ratio (log scale) |
Time in burst suppression
P = 0.30
| Outcome | POD | Without POD | P value |
|---|---|---|---|
| Duration of surgeryPOD vs without POD | median 286 (IQR 236–391) min | — not stated in the abstract | P = 0.005 |
| BIS | median 40.4 (IQR 38.1–43.4) | — not stated in the abstract | P = 0.038 |
— not stated in the abstract
Time in burst suppression
- Cumulative burst suppression time not a predictor of POD
Stepwise model (age, duration of surgery, peak power, aperiodic exponent)
- AUROC, training cohort
- 0.80 (CI 0.71-0.89, P < .001)
- AUROC, validation cohort n = 60
- 0.77 (CI 0.65-0.90, P = .001)
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
The Value of the Aperiodic Exponent of the Intraoperative Electroencephalogram for Predicting Postoperative Delirium in Elderly Patients. Anesth Analg. Published 17 March 2026. doi:10.
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