Defense Date


Document Type


Degree Name

Doctor of Philosophy


Health Related Sciences

First Advisor

T. Corey Davis, PhD, CRNA

Second Advisor

Chuck Biddle, PhD, CRNA

Third Advisor

Tyler Corson, PhD

Fourth Advisor

Ernie Steidle, PhD

Fifth Advisor

Patricia Slattum, PhD, PharmD

Sixth Advisor

Shilen Thakrar, MD


Postoperative delirium (POD) is a public health and research priority (American Society of Anesthesiologists, 2019). POD is a risk factor for long-term neurocognitive decline, and the rate of decline is directly proportional to the severity of POD (Vasunilashorn et al., 2018). Baseline cognitive function is a strong, independent predictor for POD (Culley et al., 2017). The International Perioperative Neurotoxicity Working Group recommends baseline cognitive function be assessed for older patients prior to surgery and anesthesia (Berger, et al., 2018). Perioperative cognitive screening tools trialed in anesthesia are not routinely incorporated into clinical practice related to validity, reliability, or practicality problems (Berger, et al., 2018). The ideal perioperative cognitive screening tool would be rapid, easily-administrable, valid, reliable, automatically scored, void of language, cultural, and education bias and cost-efficient (Axley & Schenning, 2015). No such tool has been identified to date. This study, guided by Donabedian’s theoretical model, evaluated the utility of a novel point-of-care (POC) electroencephalography (EEG) system, WAVi MedicalTM (Boulder, CO), for the perioperative neurocognitive assessment of older surgical patients. This study conducted a secondary analysis of data from the “Perioperative Brain Health” – IRB HM20019839 study. The “Perioperative Brain Health” study is an ongoing study collecting both pre- and postoperative questionnaire-based neurocognitive assessments alongside WAVi-derived P300 auditory evoked potentials. Data was analyzed using regression and analysis of variance. The WAVi MedicalTM system may one day offer anesthesia providers a novel neurocognitive assessment tool for predicting, identifying, and tracking perioperative neurocognitive disorders in older surgical patients.


© L. Harold Barnwell, III, PhD, DNAP, CRNA

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VCU Theses and Dissertations

Date of Submission