一个调解分析检查高风险,抗胆固醇药物使用,妄和大手术后痴呆症
Sanjay Mohanty1, Heidi Lindroth2, Lava Timsina3
1Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana; Center for Health Innovation and Implementation Science, Indianapolis, Indiana.
在手术患者中服用高剂量的抗胆固醇药物是常见的,并且与痴呆症有关,妄想起着关键作用. 减少这些药物暴露可能会改善长期的认知健康.
科学领域:
- 老年医学 老年医学
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 已知抗胆固醇药物会导致老年人的认知障碍.
- 在大手术患者中使用这些药物及其与狂妄症和痴呆症的联系尚不清楚.
研究的目的:
- 确定在接受重大手术的患者中高风险抗胆固醇药物的使用率.
- 为了研究抗胆固醇使用,妄和手术后痴呆症的发展之间的关系.
主要方法:
- 对39665名50岁以上接受住院手术的患者进行了回顾性队列研究 (2013-2019).
- 主要暴露:在住院期间服用抗胆固醇药物的剂量.
- 主要结局:在手术后1年重新诊断出痴呆症. 使用回归和调解分析进行分析.
主要成果:
- 91%的患者接受抗胆固醇药物治疗;19.1%的患者接受了六剂或更多剂量.
- 高抗胆固醇剂量与1年内痴呆的几率增加有关 (OR 2.7).
- 手术后痴呆症介导了抗胆固醇药物和痴呆症之间57.6%的关联.
结论:
- 高剂量抗胆固醇药的使用在重大手术患者中很普遍.
- 抗胆固醇药物与患痴呆症的风险更高有关,部分是由妄想中介的.
- 减少抗胆固醇药物的使用的策略可能会改善手术后的认知结果.
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