Te Pas Mariska E, Adelaars Sophie, Bouwman R Arthur, Kessels Roy P C, Olde Rikkert Marcel G M, van de Kerkhof Daan, Oosterbos Erwin, Buise Marc P
Department of Anesthesiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands.
Department of Electrical Engineering, Signal Processing Systems, Eindhoven University of Technology, Eindhoven, The Netherlands.
PLOS Digit Health. 2025 Sep 8;4(9):e0001005. doi: 10.1371/journal.pdig.0001005. eCollection 2025 Sep.
Postoperative delirium (POD) and postoperative encephalopathy (POE) are common complications in older adults undergoing aortic valve replacement (AVR), yet the predictive accuracy of cognitive screening tools remains uncertain. In this prospective cohort study, 50 patients aged 65 years and older scheduled for AVR between January and October 2022 underwent preoperative assessment with the Brain Aging Monitor Cognitive Assessment (BAMCOG) and Montreal Cognitive Assessment (MoCA). Postoperatively, POD was evaluated with the Delirium Observation Screening (DOS) scale and POE with electroencephalography (EEG). BAMCOG and MoCA showed poor accuracy in predicting POE, with AUROC values of 0.67 and 0.59 respectively, but BAMCOG demonstrated good accuracy for POD prediction (AUROC 0.85) compared with MoCA (AUROC 0.53). Higher BAMCOG scores were significantly associated with reduced POD incidence, with each 10% increase in score lowering the risk by 16%. These findings suggest that BAMCOG may be a valuable preoperative screening tool for POD, though larger studies are needed to confirm its clinical utility and establish optimal cutoff values.
术后谵妄（POD）和术后脑病（POE）是接受主动脉瓣置换术（AVR）的老年人常见的并发症，但认知筛查工具的预测准确性仍不确定。在这项前瞻性队列研究中，2022年1月至10月期间计划接受AVR的50名65岁及以上患者在术前接受了脑老化监测认知评估（BAMCOG）和蒙特利尔认知评估（MoCA）。术后，使用谵妄观察筛查（DOS）量表评估POD，使用脑电图（EEG）评估POE。BAMCOG和MoCA在预测POE方面准确性较差，曲线下面积（AUROC）值分别为0.67和0.59，但与MoCA（AUROC 0.53）相比，BAMCOG在预测POD方面显示出良好的准确性（AUROC 0.85）。较高的BAMCOG评分与POD发生率降低显著相关，评分每增加10%，风险降低16%。这些发现表明，BAMCOG可能是一种用于POD的有价值的术前筛查工具，不过需要更大规模的研究来证实其临床效用并确定最佳临界值。
