Early alpha power in the frontal lobe area can predict delirium after cardiac surgery

Abstract Background Delirium is a common postoperative complication in patients undergoing cardiac surgery and is associated with prolonged hospitalization and persistent cognitive impairment. This study aimed to assess the predictive value of alpha power in various brain regions at different time p...

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Main Authors: Fengbo Pei, Xupeng Yang, Pengfei Chen, Jinhua Wei, Yao Yao, Zhou Zhao, Hui Wu, Yi Shi, Zujun Chen
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Journal of Cardiothoracic Surgery
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Online Access:https://doi.org/10.1186/s13019-025-03576-7
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author Fengbo Pei
Xupeng Yang
Pengfei Chen
Jinhua Wei
Yao Yao
Zhou Zhao
Hui Wu
Yi Shi
Zujun Chen
author_facet Fengbo Pei
Xupeng Yang
Pengfei Chen
Jinhua Wei
Yao Yao
Zhou Zhao
Hui Wu
Yi Shi
Zujun Chen
author_sort Fengbo Pei
collection DOAJ
description Abstract Background Delirium is a common postoperative complication in patients undergoing cardiac surgery and is associated with prolonged hospitalization and persistent cognitive impairment. This study aimed to assess the predictive value of alpha power in various brain regions at different time points for postoperative delirium. Methods Patients scheduled for routine cardiac surgery were prospectively enrolled. All participants underwent 12-hour ambulatory electroencephalography (EEG) monitoring immediately upon admission to the intensive care unit (ICU). Delirium was assessed daily using the CAM-ICU criteria for five postoperative days. Alpha power in the frontal, parietal, and occipital lobes was analyzed at three time points: immediately (T0), at 6 h, and at 12 h postoperatively. Results Among the 106 patients in the training cohort, 45 developed postoperative delirium. These patients had a higher incidence of hypertension and prolonged extracorporeal circulation and aortic clamping times. Alpha power in the frontal lobe at T0 was identified as the most accurate predictor of delirium, with an area under the curve (AUC) of 0.91 (95% CI: 0.84–0.97). The validation cohort (n = 74) showed consistent results with an AUC of 0.9188 (95% CI: 0.87–0.99; P < 0.001). Conclusion Frontal lobe alpha power measured immediately postoperatively could be a reliable neurophysiological biomarker for predicting delirium after cardiac surgery, outperforming conventional clinical predictors (AUC 0.91 vs. 0.70). Graphical Abstract
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spelling doaj-art-5bfb1fe244bc4f6a95cfb594618af58b2025-08-20T03:46:24ZengBMCJournal of Cardiothoracic Surgery1749-80902025-08-012011910.1186/s13019-025-03576-7Early alpha power in the frontal lobe area can predict delirium after cardiac surgeryFengbo Pei0Xupeng Yang1Pengfei Chen2Jinhua Wei3Yao Yao4Zhou Zhao5Hui Wu6Yi Shi7Zujun Chen8Department of Cardiovascular Surgery, Peking University People’s HospitalDepartment of Cardiovascular Surgery, Peking University People’s HospitalDepartment of Cardiovascular Surgery, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, National Center for Cardiovascular DiseasesDepartment of Cardiovascular Surgery, Peking University People’s HospitalDepartment of Cardiovascular Surgery, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, National Center for Cardiovascular DiseasesDepartment of Cardiovascular Surgery, Peking University People’s HospitalDepartment of Cardiovascular Surgery, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, National Center for Cardiovascular DiseasesDepartment of Cardiovascular Surgery, Peking University People’s HospitalDepartment of Cardiovascular Surgery, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, National Center for Cardiovascular DiseasesAbstract Background Delirium is a common postoperative complication in patients undergoing cardiac surgery and is associated with prolonged hospitalization and persistent cognitive impairment. This study aimed to assess the predictive value of alpha power in various brain regions at different time points for postoperative delirium. Methods Patients scheduled for routine cardiac surgery were prospectively enrolled. All participants underwent 12-hour ambulatory electroencephalography (EEG) monitoring immediately upon admission to the intensive care unit (ICU). Delirium was assessed daily using the CAM-ICU criteria for five postoperative days. Alpha power in the frontal, parietal, and occipital lobes was analyzed at three time points: immediately (T0), at 6 h, and at 12 h postoperatively. Results Among the 106 patients in the training cohort, 45 developed postoperative delirium. These patients had a higher incidence of hypertension and prolonged extracorporeal circulation and aortic clamping times. Alpha power in the frontal lobe at T0 was identified as the most accurate predictor of delirium, with an area under the curve (AUC) of 0.91 (95% CI: 0.84–0.97). The validation cohort (n = 74) showed consistent results with an AUC of 0.9188 (95% CI: 0.87–0.99; P < 0.001). Conclusion Frontal lobe alpha power measured immediately postoperatively could be a reliable neurophysiological biomarker for predicting delirium after cardiac surgery, outperforming conventional clinical predictors (AUC 0.91 vs. 0.70). Graphical Abstracthttps://doi.org/10.1186/s13019-025-03576-7DeliriumElectroencephalogramAlpha powerCardiac surgery
spellingShingle Fengbo Pei
Xupeng Yang
Pengfei Chen
Jinhua Wei
Yao Yao
Zhou Zhao
Hui Wu
Yi Shi
Zujun Chen
Early alpha power in the frontal lobe area can predict delirium after cardiac surgery
Journal of Cardiothoracic Surgery
Delirium
Electroencephalogram
Alpha power
Cardiac surgery
title Early alpha power in the frontal lobe area can predict delirium after cardiac surgery
title_full Early alpha power in the frontal lobe area can predict delirium after cardiac surgery
title_fullStr Early alpha power in the frontal lobe area can predict delirium after cardiac surgery
title_full_unstemmed Early alpha power in the frontal lobe area can predict delirium after cardiac surgery
title_short Early alpha power in the frontal lobe area can predict delirium after cardiac surgery
title_sort early alpha power in the frontal lobe area can predict delirium after cardiac surgery
topic Delirium
Electroencephalogram
Alpha power
Cardiac surgery
url https://doi.org/10.1186/s13019-025-03576-7
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