大型手术后新出现的术后抑郁症:来自国家索赔数据库的分析
Brian O'Gara1, Juan Pablo Espinosa Leon1, Kortney Robinson2
1Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
BJA open
|September 28, 2023
概括
患上新的术后抑郁症的风险因手术程序而异. 关节骨折手术具有最高的风险,而关节置换与最低的风险有关.
科学领域:
- 医学研究 医学研究
- 外科手术的结果
- 心理健康 心理健康
背景情况:
- 手术后的抑郁症尚未得到充分了解.
- 手术后新发抑郁症的发生率和危险因素需要进一步调查.
研究的目的:
- 为了调查手术后抑郁症的发生率.
- 为了确定是否新的发病抑郁症在控制混后,根据手术类型有显著差异.
主要方法:
- 使用Optum Clinformatics Datamart.进行的回顾性队列研究.
- 通过新诊断或抗抑郁药物处方在手术后一年内确定新的术后抑郁症.
- 使用多变量考克斯回归和倾向得分匹配进行调整.
主要成果:
- 新出现抑郁症的发生率:关节骨折 (18.8%),胸切除术 (16.1%),心脏手术 (12.6%),VATS (12.4%),腹腔镜胆囊切除术 (8.6%),关节置换 (6.8%).
- 与腹腔镜胆囊切除术相比,关节骨折手术患者的风险最高 (HR 1.56),而关节置换患者的风险最低 (HR 0.55).
- 灵敏度和倾向性得分匹配的分析产生了类似的结果.
结论:
- 手术后抑郁症的风险受到手术类型的显著影响.
- 手术前的特征不能完全解释不同手术后抑郁风险的变化.
相关概念视频
Cardiomyopathy VII: Pre and Post Operative Nursing Management
15
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
15
Peripheral Artery Disease V: Postoperative Nursing Management
12
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
12
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
106
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
106
Aneurysm IV: Nursing Management
8
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
8
Peptic Ulcer Disease V: Surgical Management and Nursing Care
330
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Surgical Interventions for Peptic Ulcer Disease
330
Stages of General Anesthesia
489
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
489


