心血管外科手术后手术后妄想对5年死亡率的影响
Chisaki Yokoyama1, Kenji Yoshitnai2, Soshiro Ogata3
1Department of Anesthesiology, National Cerebral and Cardiovascular Center, 6-1, Kishibeshinmachi, Suita, Osaka, Japan.
JA clinical reports
|October 13, 2023
概括
心血管外科手术后的术后妄与5年死亡率的增加有关. 早期发现和治疗妄症对于改善这些患者的长期存活率至关重要.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 关键护理医学 关键护理医学
背景情况:
- 手术后妄想是心血管手术后的常见并发症.
- 现有研究表明,痴呆症与长期认知衰退,痴呆症和潜在死亡率之间存在联系.
- 然而,心血管外科手术后术后 Delirium 与长期死亡率之间的特定关联仍未得到充分研究.
研究的目的:
- 调查术后妄想对接受心血管手术的患者5年生存率的影响.
- 确定手术后妄想是否是该患者群体中长期死亡率的独立预测因素.
主要方法:
- 在2016年1月至2019年12月期间,对1731名接受心肺旁路心血管手术的患者进行了回顾性审查.
- 使用重症监护 Delirium 查得分 (≥3) 识别的术后 Delirium,可能包括亚临床病例.
- 考克斯比例危险建模和卡普兰-梅尔生存分析被用来评估妄和5年死亡率之间的关联.
主要成果:
- 在31.9% (562/1731) 的患者中出现了术后妄想.
- 痴呆症 (HR 1.501,p=0.025) 和紧急手术 (HR 3.380,p<0.001) 与5年死亡率显著相关.
- 在选择性手术患者中,术后妄想独立预测了更高的5年死亡率 (HR 1.987,p=0.016).
- 卡普兰-梅尔分析证实,手术后痴呆症患者的5年死亡率显著上升.
结论:
- 心血管外科手术后的术后妄与5年死亡率显著增加有关.
- 这些发现强调了识别和管理妄想的重要性,以改善心血管手术患者的长期结果.
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