术后妄想的发生率随着虚弱的严重程度的增加而增加
April Ehrlich1, Esther S Oh1,2,3,4, Kevin J Psoter5
1Division of Geriatric Medicine and Gerontology, Department of Medicine, the Johns Hopkins University School of Medicine, Baltimore, MD, USA.
在老年手术患者中,随着虚弱程度的增加,术后妄想风险显著增加. 对妄风险进行手术前咨询至关重要.
科学领域:
- 老年人手术是一门老年手术.
- 手术后并发症 手术后并发症
- 脆弱性评估 脆弱性评估
背景情况:
- 老化的外科患者群体越来越脆弱,增加了诸如术后妄想等不良结果的风险.
- 目前的二元脆弱性措施限制了细微的手术前风险评估和患者咨询.
- 手术后妄想带来了显著的发病率,死亡率和医疗保健费用.
研究的目的:
- 调查分类虚弱严重程度与术后妄想发病率之间的关联.
- 为了确定一个分级的脆弱性评估方法是否能改善妄想风险的预测.
主要方法:
- 对324名接受选择性手术的老年人进行回顾性队列分析.
- 在手术前使用埃德蒙顿脆弱度量表 (不脆弱,轻度,中度,严重) 评估脆弱性.
- 经过4A测试和混评估方法-重症监护室发现的术后妄想.
主要成果:
- 整体手术后痴呆症发生率为4.6%.
- 狂妄症的发生率随着脆弱的严重程度显著增加:2% (不脆弱),6% (轻度),23% (中度).
- 中度虚弱的患者与不虚弱的患者相比, Delirium 的几率增加了 12.10 倍.
结论:
- 手术后妄想的发生率随着较高的分类脆弱性严重程度升级而升级.
- 虚弱的严重程度,而不仅仅是存在,是预测术后妄想的一个关键因素.
- 将分级脆弱性评估整合到手术前咨询中,可以更好地告知患者手术风险.
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