Evaluating the predictive accuracy of cognitive screeners BAMCOG and MoCA in identifying postoperative delirium risk in aortic valve replacement patients: A cohort study

Postoperative delirium (POD) and postoperative encephalopathy (POE) are common complications in older adults undergoing aortic valve replacement (AVR), yet the predictive accuracy of cognitive screening tools remains uncertain. In this prospective cohort study, 50 patients aged 65 years and older scheduled for AVR between January and October 2022 underwent preoperative assessment with the Brain Aging Monitor Cognitive Assessment (BAMCOG) and Montreal Cognitive Assessment (MoCA). Postoperatively, POD was evaluated with the Delirium Observation Screening (DOS) scale and POE with electroencephalography (EEG). BAMCOG and MoCA showed poor accuracy in predicting POE, with AUROC values of 0.67 and 0.59 respectively, but BAMCOG demonstrated good accuracy for POD prediction (AUROC 0.85) compared with MoCA (AUROC 0.53). Higher BAMCOG scores were significantly associated with reduced POD incidence, with each 10% increase in score lowering the risk by 16%. These findings suggest that BAMCOG may be a valuable preoperative screening tool for POD, though larger studies are needed to confirm its clinical utility and establish optimal cutoff values.