Relative band power in assessing temporary neurological dysfunction post- type A aortic dissection surgery: a...

Area of Science:

• Neurosurgery
• Cardiovascular Surgery
• Neurophysiology

Background:

• Temporary neurological dysfunction (TND) is a frequent complication after Type A Aortic Dissection (TAAD) repair, linked to higher mortality and cognitive issues.
• Current treatments for TND are insufficient, necessitating predictive methods for early identification and intervention.
• Quantitative electroencephalography (QEEG) offers a potential tool for monitoring brain activity.

Purpose of the Study:

• To evaluate the predictive capability of postoperative relative band power (RBP) for TND following TAAD surgery.
• To identify patients at high risk of developing TND before its clinical onset.
• To establish an effective predictive model for TND in TAAD patients.

Main Methods:

• A prospective observational study involving 165 TAAD patients undergoing surgical repair.
• Postoperative bedside QEEG monitoring to record RBP changes (Delta, Theta, Beta, Alpha).
• Univariate and multivariate logistic regression analyses to identify independent risk factors for TND.

Main Results:

• 68 out of 165 patients (41.2%) developed TND.
• Independent risk factors for TND included prolonged cardiopulmonary bypass (CPB) time (≥180 min), elevated RBP Delta, and elevated RBP Theta.
• The predictive model incorporating these factors achieved an Area Under the Receiver Operating Characteristic Curve (AUROC) of 0.821.

Conclusions:

• Postoperative RBP monitoring via QEEG effectively detects brain function changes in TAAD patients.
• This monitoring provides a valuable predictive tool for TND, enabling timely clinical interventions.
• The findings support integrating RBP monitoring into perioperative care for TAAD patients to improve outcomes.