远程认知查工具在识别老年手术患者认知障碍方面的实用性:一项观察性队列研究
Ellene Yan1, Nina Butris1, Yasmin Alhamdah1
1Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada; Temerty Faculty of Medicine, University of Toronto, ON, Canada.
Journal of clinical anesthesia
|July 24, 2024
概括
电话蒙特利尔认知评估 (T-MoCA) 确定了在老年手术患者中最可疑的认知障碍,而其他工具显示一致性较差. 像OSA,功能障碍和抑郁症等风险因素与阳性查有关.
科学领域:
- 老年医学 老年医学
- 神经科学是一个神经科学.
- 公共卫生 公共卫生
背景情况:
- 认知障碍在老年人中普遍存在,特别是那些接受手术的人.
- 准确和高效的查工具对于识别有风险的个人至关重要.
研究的目的:
- 通过使用四种不同的查工具,评估老年手术患者怀疑认知障碍的患病率.
- 为了评估疾病控制和预防中心 (CDC) 认知问题,确定痴呆症八项问卷 (AD8),认知状态 (TICS-M) 修改电话访谈和蒙特利尔认知评估 (T-MoCA) 之间的协议.
- 识别与认知查结果呈阳性的风险因素.
主要方法:
- 一项多中心前性研究,涉及307名65岁及以上的非心脏手术患者.
- 使用CDC认知问题,AD8,TICS-M和T-MoCA进行了远程手术前评估.
- 计算了流行率和一致性 (科恩的卡帕),并进行了风险因素分析.
主要成果:
- 在T-MoCA检测到的患病率最高 (28%),其次是AD8 (17%),CDC认知问题 (9%) 和TICS-M (6%).
- 这四种工具都表现出不太好的共识,只不过是偶然的.
- 风险因素因工具而异:抑郁症与CDC,OSA和功能障碍与AD8,年龄较大,男性性别和TICS-M和T-MoCA的疼痛.
结论:
- T-MoCA,AD8,CDC认知问题和TICS-M可用于老年手术患者的远程手术前认知查.
- 特定的条件,如OSA,功能障碍和抑郁症与某些工具的积极屏幕有关.
- 远程认知查可以帮助脆弱患者群体的风险分层.
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