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Primary Healthcare Services01:30

Primary Healthcare Services

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Primary care promotes wellness and prevents disease. This care includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations. Settings providing this type of healthcare include physician offices, public health clinics, school nursing, and community health nursing.
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
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Levels of Health Promotion and Illness Prevention01:26

Levels of Health Promotion and Illness Prevention

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Health promotion allows a person to control the determinants of health, resulting in an improved health status. It enhances the quality of life and reduces premature deaths. Health promotion and illness prevention programs help people make beneficial choices to reduce the risk of disease and disabilities. There are three health promotion and illness prevention levels: primary, secondary, and tertiary prevention.
In primary prevention, actions taken before disease onset prevent the disease from...
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Preventive Healthcare Services01:30

Preventive Healthcare Services

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Preventive healthcare services keep people healthy via frequent check-ups, screening, and counseling. They primarily aid in disease prevention rather than treating an acute or chronic illness. Preventive treatment also keeps individuals productive and energetic, allowing them to work well into their retirement years. Examples of preventive care services include:
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Principles of Disease Surveillance01:26

Principles of Disease Surveillance

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Disease surveillance is the systematic collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practice. This process integrates data dissemination to entities responsible for preventing and controlling disease, injury, and disability. Surveillance systems provide crucial information for action, helping public health authorities make informed decisions to manage and prevent outbreaks, ensure public safety, optimize...
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Healthcare Agencies II01:17

Healthcare Agencies II

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There are various healthcare agencies in the United States—some of which are managed by religious institutions and others by different government branches.
Parish nursing is a growing specialty nursing profession that focuses on holistic healthcare, health promotion, and illness prevention. It blends professional nursing practice with a health ministry, focusing on health and healing within the context of a Christian community. Parish nurses serve as health educators, referral sources,...
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Methods Of Healthcare Delivery System01:26

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At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
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公衆衛生

Wendy Wy Huang1, Shirley Fan2, Wei-Ya Li3

  • 1School of Medicine, University of Limerick, Limerick, Munster, Ireland.

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まとめ
この要約は機械生成です。

非心臓手術を受けた高齢者の23%が術後7日目までに術後神経認知障害（POCD）を発症し、時間の経過とともに減少する。腹部手術は整形外科手術よりもPOCDのリスクが高いため、周術期管理の改善が必要である。

キーワード:
高齢者術後神経認知障害非心臓手術疫学腹部手術整形外科手術

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科学分野:

  • 老年医学; 神経科学; 外科的転帰

背景:

  • 高齢の外科患者は、併存疾患と加齢により神経認知障害のリスクが増加する。この集団における術後神経認知障害（POCD）の有病率については、さらなる調査が必要である。本研究は、非心臓手術を受けた高齢者に焦点を当てる。

研究 の 目的:

  • 非心臓手術を受けた高齢者における周術期神経認知障害（POCD）のプールされた有病率を推定する。術後のPOCDの時間的傾向を分析する。異なる手術タイプ間のPOCD有病率を比較する。

主な方法:

  • 2024年1月24日までに発表された研究の系統的レビューとメタアナリシス。周術期の認知評価を受けた60歳以上の非心臓手術を受けた入院患者を含める。プールされた有病率の計算にはランダム効果モデルを使用。品質評価にはニューカッスル・オタワ尺度とMOOSEガイドラインを使用。

主要な成果:

  • 分析対象は39件の研究（12,921人の患者）、平均年齢70.0±8.9歳、女性44.3%。全体的なPOCD有病率：23%（7日目）、16%（1ヶ月）、10%（3ヶ月）、3%（1年）。腹部手術は、7日目と3ヶ月目で整形外科手術よりもPOCD有病率が高かった。

結論:

  • POCDは、非心臓手術を受けた高齢患者に蔓延しており、術後7日目と1ヶ月後には有意な割合を示す。腹部手術は、整形外科手術と比較してPOCDのリスクが高いことに関連している。認知スクリーニング、リスク軽減、介入は、より良い周術期管理と転帰のために不可欠である。