Delirium detection using relative delta power based on 1-minute single-channel EEG: a multicentre study

Area of Science:

• Neuroscience
• Geriatric Medicine
• Medical Technology

Background:

• Delirium is often unrecognized in clinical practice.
• Electroencephalography (EEG) shows slower frequencies during delirium, suggesting its potential for detection.
• A brief, single-channel EEG recording was investigated for its discriminative performance in identifying delirium.

Purpose of the Study:

• To evaluate the diagnostic value of a brief, single-channel EEG recording for detecting delirium in postoperative patients.
• To assess the discriminative performance of relative delta power (1-4 Hz) from EEG in an independent cohort.

Main Methods:

• A prospective, multicentre study included 159 postoperative patients aged 60 years or older.
• A 5-min EEG recording was obtained before operation and during the first 3 postoperative days.
• Relative delta power was calculated from artifact-free EEG, and its diagnostic accuracy was assessed using the area under the receiver operating characteristic curve (AUROC).

Main Results:

• Delirium or possible delirium was identified on 84 (23.3%) of the postoperative days.
• The AUROC for relative EEG delta power (1-4 Hz) was 0.75 (95% CI 0.69-0.82).
• Exploratory analysis revealed a higher AUROC of 0.78 (95% CI 0.72-0.84) for relative power in the 1-6 Hz range.

Conclusions:

• A single-channel EEG recording, automatically analyzed, can detect delirium in older postoperative patients.
• This objective detection method, offering a continuous scale, is a promising approach for routine delirium screening.
• The findings support the use of EEG-based analysis for improved delirium recognition.