# EEG‐Derived Index Predicts Postoperative Delirium in Elderly Patients With Hip Fracture: A Prospective Study From a Tertiary Medical Center

## TL;DR

This study shows that an EEG-based Delirium Index (DELi) can help predict postoperative delirium in elderly hip fracture patients when combined with cognitive and frailty assessments.

## Contribution

The study introduces a novel EEG-derived Delirium Index (DELi) for preoperative prediction of postoperative delirium in elderly hip fracture patients.

## Key findings

- DELi strongly correlates with CAM scores (r = 0.516, p < 0.0001) and accurately predicts POD (AUC = 0.791).
- A composite model using DELi, MoCA, and FRAIL scores achieves excellent discrimination (AUC = 0.922) with high sensitivity and specificity.

## Abstract

Postoperative delirium (POD) remains challenging to predict in elderly hip fracture patients. This study posited that a newly developed electroencephalogram‐derived metric, termed the Delirium Index (DELi), has the potential to elucidate latent information pertaining to the preoperative predisposing factors of POD.

A prospective cohort of 144 elderly patients undergoing hip fracture surgery was enrolled. DELi scores were derived from preoperative electroencephalography (EEG) using wavelet analysis. POD was diagnosed using the Confusion Assessment Method (CAM). Predictive performance was evaluated via ROC analysis, logistic regression, and bootstrapping validation.

DELi demonstrated strong correlation with CAM scores (r = 0.516, p < 0.0001) and good predictive accuracy for POD (AUC = 0.791, 95% CI: 0.715–0.867). A composite model integrating DELi, Montreal Cognitive Assessment (MoCA), and FRAIL scores achieved excellent discrimination (AUC = 0.922, 95% CI: 0.878–0.965), with 85.9% sensitivity and 86.3% specificity.

The DELi index, combined with cognitive and frailty assessments, provides a practical tool for preoperative POD risk stratification in elderly hip fracture patients.

ChiCTR2200060389