老年患者早期术后神经认知并发症:比较那些有和没有先前存在的轻度认知障碍的人 - - 一项前性研究
Pawit Somnuke1, Pensiri Srishewachart1, Chalita Jiraphorncharas2
1Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 10700, Bangkok, Thailand.
BMC geriatrics
|January 23, 2024
概括
在老年手术患者中,患有轻度认知障碍 (MCI) 和没有轻度认知障碍 (MCI) 的术后妄 (POD) 发生率相似. 然而,没有MCI的患者患上术后认知功能障碍 (POCD) 的比率更高.
科学领域:
- 老年医学 老年医学
- 麻醉学 麻醉学
- 神经科学是一个神经科学.
背景情况:
- 人口老龄化导致老年人手术的增加.
- 手术后妄 (POD) 和认知功能障碍 (POCD) 在老年手术患者中很常见.
- 许多老年手术患者有先前存在的轻度认知障碍 (MCI),但其与POD的联系尚不清楚.
研究的目的:
- 调查POD的发病率在老年手术患者和没有先前存在的MCI.
- 为了比较这些群体之间的POCD和其他术后并发症的发病率.
主要方法:
- 对279名60岁以上接受重大手术的患者进行前性研究.
- 使用蒙特利尔认知评估 (MoCA) 评分 (18-24) 评估的手术前MCI.
- 根据DSM-5标准诊断的POD;POCD定义为MoCA分数下降≥2分.
主要成果:
- POD发生率相似:MCI组的16.6%,而非MCI组的14.3% (P=0.839).
- 在非MCI组中,POCD发病率明显高于非MCI组 (50%),而不是MCI组 (24.3%) (P=0.001).
- 患有MCI的群体在视觉空间,注意力和导向领域出现下降;非MCI群体在大多数领域下降.
结论:
- 在老年手术患者中,先前存在的MCI并没有增加POD风险.
- 没有MCI的老年患者在手术后患POCD的风险更高.
- 术后认知评估对所有老年手术患者至关重要,包括那些以前认知正常的人.
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