术前营养不良对术后妄想的影响:系统性审查和元分析
Bo Dong1,2, Jing Wang1, Pan Li1
1Department of Anesthesiology, Hebei General Hospital, Shijiazhuang, 050051, China.
Perioperative medicine (London, England)
|October 26, 2023
概括
手术前的营养不良显著增加了手术后痴呆症 (POD) 的风险. 早期营养评估对于识别有风险的个体和减轻不良结果至关重要.
科学领域:
- 医学科学 医学科学 医学科学
- 外科手术的结果
- 营养科学 营养科学
背景情况:
- 手术后妄 (POD) 是手术后常见的并发症,与诸如认知衰退和死亡率增加等不良结果有关.
- 营养不良,定义为营养缺乏,是POD的疑似危险因素,但现有的证据是相互矛盾的.
研究的目的:
- 系统地审查和元分析术前营养不良与POD发病率之间的相关性.
- 提供关于营养不良作为POD可修改的风险因素的全面证据.
主要方法:
- 使用主要科学数据库 (PubMed,Embase,Cochrane图书馆,Web of Science) 进行了前性队列研究的系统审查和元分析.
- 两位独立研究人员进行了文献选择,数据提取和质量评估 (纽卡斯尔-太华尺度).
- 几率比率 (ORs) 和95%置信区间 (CI) 被计算出来,以量化术前营养不良和POD之间的关联.
主要成果:
- 包括7项涉及2701名患者的研究. 手术前营养不良的综合流行率为15.1%,手术后营养不良发生在15.8%的患者中.
- 手术前的营养不良独立地与POD风险增加有关 (合并OR=2.32,95%CI1.62-3.32).
- 亚组分析显示,在非心脏手术和使用小型营养评估简单表格 (MNA-SF) 进行营养不良评估时存在显著的关联.
结论:
- 手术前的营养不良是成年手术患者手术后痴呆症的重要独立风险因素.
- 在手术前对营养状况的评估可能有助于识别患有POD风险较高的患者.
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