术前预后营养指数预测手术后老年患者的术后妄想:一项匹配的队列研究
Yu-Xiang Song1, Qian Wang2, Yu-Long Ma1
1Department of Anaesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China.
General hospital psychiatry
|December 15, 2023
概括
手术前预后营养指数 (PNI) 可以预测手术后痴呆症 (POD) 在接受手术的老年患者. 改善营养状况可能有助于预防这一群体的POD.
科学领域:
- 老年医学 老年医学
- 手术瘤学手术瘤学
- 临床营养学 临床营养学
背景情况:
- 预后营养指数 (PNI) 是患者营养和免疫状况的关键指标.
- 手术后痴呆症 (POD) 是老年手术患者常见的并发症,影响了康复和结果.
- 鉴定POD的预测因素对于 geriatric手术护理的有针对性的干预至关重要.
研究的目的:
- 调查术前预后营养指数 (PNI) 与术后狂妄症 (POD) 的发生之间的关联.
- 评估在接受非神经外科和非心脏手术的老年患者中PNI对POD的预测价值.
主要方法:
- 追溯队列研究,包括29814名接受非神经外科和非心脏外科手术的老年患者 (2014年1月 - 2019年8月).
- 使用单变量和多变量物流回归分析的POD和PNI之间的相关性.
- 倾向分数匹配 (PSM) 和治疗权重的逆概率 (IPTW) 用于控制混因素.
主要成果:
- 使用ROC曲线分析确定了46.01的PNI截止值.
- 在各种回归模型中,较低的手术前PNI (≤46.01) 与POD风险增加显著相关 (ORs范围从1.356到2.573,P<0.001).
- 两种PSM和IPTW模型都证实了POD的PNI的独立预测值.
结论:
- 术前预后营养指数 (PNI) 显示,在接受重大非神经外科和非心脏手术的老年患者中,术后 Delirium (POD) 的显著预测价值.
- 保持或改善手术前的营养状况,如PNI所示,可能是一个可行的策略,以减少这一患者群体中POD的发病率.
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