代谢综合征和术后妄想和术后认知功能障碍的风险:一个多中心队列研究
Insa Feinkohl1, Jürgen Janke2, Arjen J C Slooter3
1Witten/Herdecke University, Medical Biometry and Epidemiology Group, Witten, Germany; Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany.
British journal of anaesthesia
|June 21, 2023
概括
代谢综合征增加了老年手术患者手术后 Delirium (POD) 的风险. 更高的身体质量指数 (BMI) 与术后认知功能障碍 (POCD) 有关,而更高的HDL-C降低了POD风险.
科学领域:
- 老年学是一门学科.
- 神经科学是一个神经科学.
- 代谢健康 代谢健康
背景情况:
- 代谢综合征及其组成部分是认知障碍的已知危险因素.
- 代谢综合征对术前神经认知障碍的具体贡献,如术后痴呆症 (POD) 和术后认知功能障碍 (POCD),仍然在很大程度上是未知的.
- 这项研究调查了代谢参数与老年手术患者POD和POCD风险之间的关联.
研究的目的:
- 检查代谢综合征及其组成部分与老年手术患者POD和POCD风险之间的关联.
- 确定特定的代谢参数,可以作为这些外科手术期间神经认知障碍的预测因子.
主要方法:
- 一组65岁及以上的765名接受手术的参与者被评估了手术前的代谢参数.
- 手术后妄 (POD) 在手术后7天内进行查,手术后认知功能障碍 (POCD) 在3个月后使用神经心理测试和与非手术对照进行比较进行评估.
- 采用多个逻辑回归分析来确定代谢参数与POD和POCD的关联,根据年龄,性别和手术类型进行调整.
主要成果:
- 19.5%的患者患有POD,10.1%的患者在3个月后患有POCD.
- 代谢综合征患者患POD的风险高出1.85倍.
- 更高的高密度脂蛋白胆固醇 (HDL-C) 与POD风险降低有关,而更高的身体质量指数 (BMI) 与POCD风险增加有关.
结论:
- 代谢综合征的老年手术患者面临POD的风险增加.
- 降低的HDL-C水平与POD有显著的联系,而高的手术前BMI则成为POCD的危险因素.
- 这些发现突出了POD和POCD的不同流行病学概况,并表明了查计划的潜在实用性,其中包括HDL-C和BMI测量,以减轻外科期神经认知障碍.
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