Observational studyInternational journal of surgery (London, England)2025
Developing predictive nomogram models using quantitative electroencephalography for brain function in type a aortic dissection: a prospective observational study.
Observational study in International journal of surgery (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Risk prediction models for postoperative delirium in adult patients undergoing cardiac surgery: a systematic review and meta-analysis.BMC cardiovascular disorders · 2026Pooled it
- Neurophysiological signatures of latent brain vulnerability in perioperative neurocognitive disorders: integrating EEG, cerebral oximetry, and processed EEG.Frontiers in medicine · 2026Review
- Transposition of an isolated left vertebral artery during aortic arch replacement for Stanford type A aortic dissection.Journal of thoracic disease · 2025Article
- Health needs assessment: development of a simplified risk probability scale design for rapid mental health screening in emergency frontline rescue teams.Frontiers in public health · 2025Article
- Development and validation of a nomogram prediction model for factors influencingFrontiers in endocrinology · 2025Article
- Clinical efficacy and mechanisms of transcutaneous auricular vagus nerve stimulation targeting the gut-brain axis for postoperative complications of aortic dissection: study protocol for a randomized controlled trial.Frontiers in medicine · 2025Article
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11 authors.
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Abstract
backgroundType A aortic dissection (TAAD) remains a significant challenge in cardiac surgery, presenting high risks of adverse outcomes such as permanent neurological dysfunction and mortality despite advances in medical technology and surgical techniques. This study investigates the use of quantitative electroencephalography (QEEG) to monitor and predict neurological outcomes during the perioperative period in TAAD patients.
methodsThis prospective observational study was conducted at the hospital, involving patients undergoing TAAD surgery from February 2022 to January 2023. QEEG parameters, including the dynamic amplitude-integrated electroencephalography (aEEG) grade, which assesses changes in brain function over time, alongside aEEG and relative band power (RBP), were monitored and analyzed to assess brain function preoperatively, intraoperatively, and within 2 hours postoperatively. A predictive nomogram model was developed using these QEEG metrics along with other clinical variables to forecast neurological outcomes.
resultsIn this study, we analyzed the factors contributing to adverse outcomes (AO) and transient neurological dysfunction (TND) following TAAD surgery. For AO, multivariable analysis identified pre-mental status (odds ratio [OR] = 4.652, 95% confidence interval [CI] = 2.316-10.074, P < 0.001), cardiopulmonary bypass time (OR = 1.014, 95% CI = 1.006-1.023, P = 0.001), and dynamic aEEG grade (OR = 9.926, 95% CI = 4.493-25.268, P < 0.001) as independent risk factors. The AO model showed high discriminative ability with an area under the curve of 0.888 (95% CI = 0.818-0.960) and good calibration (Brier score = 0.0728). For TND, significant preoperative differences included dynamic aEEG grade ( P < 0.001) and Log(Post-RBP Alpha%) (6.00 vs. 4.00, P < 0.001). Multivariable analysis identified cardiopulmonary bypass time (OR = 1.014, 95% CI = 1.006-1.023, P = 0.001), Post-RBP Alpha% (OR = 0.263, 95% CI = 0.121-0.532, P < 0.001), and dynamic aEEG grade (OR = 12.444, 95% CI = 5.337-30.814, P < 0.001) as independent risk factors. The TND model had an area under the curve of 0.893 (95% CI = 0.844-0.941) and good calibration (Brier score = 0.125). These findings highlight the role of QEEG in predicting postoperative neurological dysfunction in TAAD patients.
conclusionThrough perioperative QEEG monitoring of TAAD patients, combined with clinical indicators such as cardiopulmonary bypass time and preoperative mental status, we developed clinical predictive models for AO and TND after surgery. These models allow for early detection of postoperative brain function impairment, as assessed by QEEG parameters monitored intraoperatively and during the first 2 hours after surgery, a period chosen based on clinical definitions of delayed awakening and supported by the findings of this study. This study provides evidence supporting postoperative brain function monitoring in TAAD patients, with potential clinical implications for improved outcomes.
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