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在大屠杀幸存者中,手术前的认知障碍和手术后的妄想,他们实现了长寿
Yotam Weiss1, Shiri Zarour1, Yossef Kiselevich1
1Division of Anesthesia, Intensive Care, and Pain Management, Tel-Aviv Medical Center, Tel-Aviv University, Tel-Aviv, Israel.
Journal of the American Geriatrics Society
|March 14, 2024
概括
经过手术的75岁以上的大屠杀幸存者 (HS) 与对照者表现出类似的认知障碍和妄想率. 然而,HS患者的跌倒和其他不良事件较多,需要持续专业护理.
科学领域:
- 老年医学 老年医学
- 外科手术的结果
- 神经认知障碍 神经认知障碍
背景情况:
- 大屠杀幸存者 (HS) 面临更高的生理和心理问题的风险,可能会增加外科手术期间的脆弱性.
- 关于接受手术的老年HS神经认知障碍的数据有限.
研究的目的:
- 为了评估75岁以上的大屠杀幸存者 (HS) 接受选择性手术的手术前认知障碍,手术后妄和其他并发症.
- 为了比较HS和对照组之间的这些结果.
主要方法:
- 对1332名75岁以上的患者 (422名HS) 进行了回顾性队列研究,这些患者接受了选择性非心脏手术.
- 通过4A's-Test (4AT),3分钟诊断混乱评估方法 (3D-CAM) 和CHART-DEL评估使用Mini-Cog和术后妄想的术前认知障碍.
- 多变量回归分析了手术后 Delirium 的风险因素.
主要成果:
- 在HS和对照人群之间,在术前认知障碍 (24%) 或术后妄想 (16%) 中没有显著差异.
- 在HS患者中,复合不良事件的风险较高 (24%对20%),主要是由于跌倒的增加 (4%对2%).
- 对于HS患者来说,他们更有可能没有孩子,并且长期使用抗抑郁药和二二类药的比例更高.
结论:
- 在大屠杀幸存者 (HS) 中,长寿与术前认知障碍或术后妄想症的风险增加无关.
- 尽管认知结果相似,但HS需要专门的护理,因为其他外科手术后并发症的发生率更高,特别是跌倒.
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