在接受胃肠道外科手术的老年患者中出现术后妄想的危险因素:单中心回顾性研究
Tomoyuki Sugi1, Tsuyoshi Enomoto1, Yusuke Ohara1
1Department of Gastrointestinal and Hepatobiliary-Pancreatic Surgery, Faculty of Medicine University of Tsukuba Tsukuba Ibaraki Japan.
在手术前的老年医学评估中,在接受胃肠道癌症手术的老年患者中,确定了术后痴呆症的关键风险因素. 低身体功能,营养不良,认知障碍和二胺使用预测狂妄风险.
科学领域:
- 老年医学 老年医学
- 手术瘤学手术瘤学
- 神经科学是一个神经科学.
背景情况:
- 手术后痴呆症 (POD) 在接受重大手术的老年患者中是一个重大问题.
- 胃肠道癌症手术由于患者年龄和疾病复杂性而带来独特的风险.
- 早期识别风险患者对于有针对性的干预至关重要.
研究的目的:
- 在接受选择性胃肠道癌症手术的老年患者中研究术前痴呆症的风险因素.
- 确定与POD相关的特定老年病评估参数.
主要方法:
- 对158名75岁或以上的患者进行前性研究,这些患者接受了急性胃肠道癌症手术 (2020年5月 - 2022年3月).
- 在手术前的老年医学评估包括虚弱,身体功能 (短身体性能电池 - SPPB),营养 (迷你营养评估 - MNA) 和认知 (迷你精神状态检查 - MMSE).
- 使用混评估方法诊断的术后妄想;通过多变量逻辑回归分析的风险因素.
主要成果:
- 34% (53/158) 的患者出现了术后狂妄症.
- 确定了独立的手术前风险因素:SPPB得分≤9,MNA得分≤11,MMSE得分≤24,以及定期使用二.
- 单变量分析还显示了与年龄的关联,睡眠药物使用,查尔森并发症指数,表现状况,弗里德的脆弱性得分和握力弱.
结论:
- 术前老年病学评估结果,特别是低SPPB,MNA和MMSE得分,是该人群中POD的重要风险因素.
- 定期使用二是POD的独立预测因子.
- 这些发现强调了全面的老年病学评估对老年外科瘤患者POD风险分层的重要性.
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