心脏外科手术相关激动性妄想的动态预测分数:单中心回顾性观察性研究
Yu Tian1, Bingyang Ji2, Xiaolin Diao3
1Department of Anesthesiology, Beijing AnZhen Hospital, Capital Medical University, Beijing, China.
Journal of cardiothoracic surgery
|July 6, 2023
概括
一个新的动态评分系统有助于预测心脏手术后 Delirium 的风险. 这种工具有助于早期识别和干预术后痴呆症,改善患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 老年医学 老年医学
背景情况:
- 手术后妄 (POD) 管理侧重于预防,查和早期治疗.
- 客观的评分系统对于心脏手术患者 Delirium 风险的分层至关重要.
研究的目的:
- 开发和验证动态评分系统,用于预测心脏手术后妄想风险.
- 改善POD早期识别和干预策略.
主要方法:
- 一项对57,180名接受心脏手术的患者的回顾性研究 (2012年1月 - 2019年1月).
- 患者被分为导出 (n=45,744) 和验证 (n=11,436) 队列.
- 多变量逻辑回归被用来制定在手术前,ICU入院和ICU入院后24小时的痴呆症 (AD) 预测系统.
主要成果:
- 阿尔茨海默病的患病率为3.6% (2,085/57,180).
- 关键预测因素包括手术前LVEF≤45%,肌素>100μmol/L,紧急手术,CAD,出血>600毫升,手术内使用血小板/血,以及术后LVEF≤45%.
- 预测曲线下的面积 (AUC) 值为0.68 (手术前),0.74 (ICU入院) 和0.75 (术后). 对多个时间点模型 (P=0.49,P=0.35) 的校准很好.
结论:
- 使用外科手术期间数据的动态评分系统有效预测心脏手术后妄想风险.
- 这种评分系统有潜力提高的早期检测和管理.
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