术内低血压和术后妄想之间的关联:一个回顾性队列分析
Shiri Zarour1, Yotam Weiss1, Maher Abu-Ghanim1
1Division of Anesthesia, Intensive Care, and Pain Management, Tel-Aviv Medical Center, Tel-Aviv University, Tel-Aviv, Israel.
Anesthesiology
|July 12, 2024
概括
这项研究发现,在接受选择性非心脏手术的老年患者中,手术内低血压和术后狂妄之间没有关联. 需要进一步的研究来澄清手术患者之间的这种关系.
科学领域:
- 麻醉学 麻醉学
- 老年医学 老年医学
- 神经科学是一个神经科学.
背景情况:
- 术后低血压是由于大脑输液减少而导致术后狂妄的潜在危险因素.
- 目前关于手术内低血压和术后妄想之间的联系的证据是不确定的.
- 这项研究调查了接受选择性非心脏手术的老年患者的相关性.
研究的目的:
- 测试假设,在70岁以上的接受选择性非心脏手术的患者中,手术内低血压与术后妄想有关.
主要方法:
- 对2352名70岁以上的患者进行回顾性队列分析,这些患者接受了选择性非心脏手术.
- 术内低血压量化为平均动脉压下面积 (MAP) < 65 mmHg.
- 使用4A测试和基于图表的痴呆症识别仪器评估术后痴呆症.
- 多变量逻辑回归用于分析关联,调整混因子.
主要成果:
- 手术后狂妄的总体发病率为14%.
- 在调整了混变量之后,手术内低血压与术后妄想没有显著的关联.
- 在低血压四分位数中没有观察到 Delirium 的风险增加,调整后的几率比率接近 1.
结论:
- 在这个队列中观察到的范围内,手术内低血压似乎与接受选择性非心脏手术的老年患者的术后狂妄症无关.
- 这些发现表明,在这种患者群体中,其他因素可能在 Delirium 的发展中发挥更重要的作用.
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