执行和语言功能的认知缺陷预测了手术后妄想
Cynthia Olotu1, Lisa Lebherz2, Leonie Ascone3
1Department of Anaesthesiology, University Medical Center Hamburg, Hamburg, Germany.
Journal of cardiothoracic and vascular anesthesia
|October 1, 2023
概括
老年人中术后妄想 (POD) 风险可以通过特定的认知测试来预测. 执行功能受损和语言技能是手术后发展POD的关键指标.
科学领域:
- 老年医学 老年医学
- 神经科学是一个神经科学.
- 麻醉学 麻醉学
背景情况:
- 手术后妄 (POD) 是接受手术的老年人常见的并发症.
- 认知障碍,尤其是轻度认知障碍,是POD的重要危险因素.
- 风险患者的手术前识别对于有针对性的妄想预防策略至关重要.
研究的目的:
- 确定预测老年人POD发展的特定认知领域.
- 提高术前认知测试的敏感性,以评估POD风险.
- 为指导在术后期应用预防措施的指导.
主要方法:
- 一项随机对照试验的二次分析,该试验涉及60岁及以上的患者.
- 进行了手术前的神经心理测试和妄查.
- 多重后勤回归被用来确定POD认知测试的预测价值.
主要成果:
- 该研究包括541名患者,POD发病率为15.6%.
- 在Trail Making Test B/A的性能下降和字母流性显著预测了POD风险.
- 后勤回归模型显示出良好的区分能力 (AUC = 0.786).
结论:
- 执行功能和语言技能,包括记忆,抑制和处理速度,与POD发展密切相关.
- 这些发现强调了在手术前评估特定认知领域的重要性.
- 基于这些认知预测因素的有针对性的干预措施可以改善老年手术患者的POD预防.
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