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已发表论文
脑电图引导全身麻醉对 60 岁以上髋部骨折患者术后谵妄及恢复的影响：一项回顾性队列研究
Authors Liu Y, Fan H, Wei G, Shu Y, Zhang J
Received 27 August 2025
Accepted for publication 12 December 2025
Published 25 December 2025 Volume 2025:21 Pages 2895—2910
DOI https://doi.org/10.2147/NDT.S563641
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 5
Editor who approved publication: Professor Taro Kishi
Yang Liu,1,* Hong Fan,1,* Guohua Wei,2 Yinyin Shu,1 Jigang Zhang2
1Department of Anesthesiology, Jinling Hospital Affiliated to Nanjing University School of Medicine, Nanjing, Jiangsu, 210002, People’s Republic of China; 2Department of Anesthesia and Perioperative Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jigang Zhang, Department of Anesthesia and Perioperative Medicine, the First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, Jiangsu, 210002, People’s Republic of China, Email 18752035417@163.com
Background: Hip fractures in the elderly often lead to high morbidity, prolonged hospitalization, and postoperative delirium—a prevalence noted to affect up to 50% of such patients. This study evaluates whether electroencephalogram (EEG)-guided general anesthesia can reduce postoperative delirium and enhance recovery in elderly hip fracture cases.
Methods: This retrospective cohort study analyzed patients aged ≥ 60 years who underwent hip fracture surgery under general anesthesia from November 2022 to May 2024. After propensity score matching, patients were divided into two groups: routine anesthesia (n=118) and EEG-guided anesthesia (n=105). Outcomes measured included the incidence of delirium (Confusion Assessment Method), cognitive recovery (SLUMS, Saint Louis University Mental Status Examination), hospital stay duration, post-anesthesia care unit (PACU) stay duration, and patient satisfaction.
Results: The EEG-guided group showed significant reductions in the incidence of postoperative delirium on the first and third days (8.57% vs 20.34%, P= 0.014, and 8.57% vs 22.88%, P= 0.004, respectively). However, this difference was no longer significant on the fifth day and thereafter. The EEG-guided group also demonstrated better early cognitive recovery with higher SLUMS scores on postoperative days 1 and 3 (both P= 0.008). Hospitalization outcomes favored the EEG-guided group, with shorter PACU retention and hospital stays (P < 0.001 and P= 0.008, respectively). Patient satisfaction was significantly higher in the EEG-guided group (P= 0.007). Logistic regression identified EEG-guided anesthesia as a protective factor against delirium (OR 0.316; 95% CI, 0.134– 0.685; P= 0.005), reduced burst suppression duration, and reduced propofol dosage.
Conclusion: EEG-guided general anesthesia seems to be associated with lower rates of early postoperative delirium and improved cognitive recovery in elderly patients with hip fractures.
Keywords: electroencephalography, anesthesia, elderly patients, delirium, cognition disorders, patient satisfaction
1Department of Anesthesiology, Jinling Hospital Affiliated to Nanjing University School of Medicine, Nanjing, Jiangsu, 210002, People’s Republic of China; 2Department of Anesthesia and Perioperative Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jigang Zhang, Department of Anesthesia and Perioperative Medicine, the First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, Jiangsu, 210002, People’s Republic of China, Email 18752035417@163.com
Background: Hip fractures in the elderly often lead to high morbidity, prolonged hospitalization, and postoperative delirium—a prevalence noted to affect up to 50% of such patients. This study evaluates whether electroencephalogram (EEG)-guided general anesthesia can reduce postoperative delirium and enhance recovery in elderly hip fracture cases.
Methods: This retrospective cohort study analyzed patients aged ≥ 60 years who underwent hip fracture surgery under general anesthesia from November 2022 to May 2024. After propensity score matching, patients were divided into two groups: routine anesthesia (n=118) and EEG-guided anesthesia (n=105). Outcomes measured included the incidence of delirium (Confusion Assessment Method), cognitive recovery (SLUMS, Saint Louis University Mental Status Examination), hospital stay duration, post-anesthesia care unit (PACU) stay duration, and patient satisfaction.
Results: The EEG-guided group showed significant reductions in the incidence of postoperative delirium on the first and third days (8.57% vs 20.34%, P= 0.014, and 8.57% vs 22.88%, P= 0.004, respectively). However, this difference was no longer significant on the fifth day and thereafter. The EEG-guided group also demonstrated better early cognitive recovery with higher SLUMS scores on postoperative days 1 and 3 (both P= 0.008). Hospitalization outcomes favored the EEG-guided group, with shorter PACU retention and hospital stays (P < 0.001 and P= 0.008, respectively). Patient satisfaction was significantly higher in the EEG-guided group (P= 0.007). Logistic regression identified EEG-guided anesthesia as a protective factor against delirium (OR 0.316; 95% CI, 0.134– 0.685; P= 0.005), reduced burst suppression duration, and reduced propofol dosage.
Conclusion: EEG-guided general anesthesia seems to be associated with lower rates of early postoperative delirium and improved cognitive recovery in elderly patients with hip fractures.
Keywords: electroencephalography, anesthesia, elderly patients, delirium, cognition disorders, patient satisfaction