对接受重大选择性手术的老年人进行常规认知查:益处,风险和成本
Luke Km Chan1,2, Alwin Chuan3,4, Christophe R Berney4,5
1Gold Coast University Hospital, Southport, Queensland, 4215, Australia.
Anaesthesia and intensive care
|August 30, 2024
概括
建议所有老年患者进行手术后痴呆症的常规术前查. 这种方法具有成本效益,并且比针对性查或常规干预更有利于预防妄想.
科学领域:
- 老年医学 老年医学
- 麻醉学 麻醉学
- 神经科学是一个神经科学.
背景情况:
- 认知障碍和年龄较大是术后 Delirium 的关键风险因素.
- 建议进行手术前查,以确定患有痴呆症的风险患者进行痴呆症预防干预.
- 目前的指导方针缺乏关于常规与有针对性的查以及首选工具的明确性.
研究的目的:
- 审查手术前常规查术后 Delirium 的好处和风险.
- 进行成本效益分析,比较常规查与不进行查.
- 总结现有查工具的性能,并讨论新出现的选项.
主要方法:
- 对利益和风险进行系统审查.
- 常规查与不进行查的成本效益分析.
- 常见和不断变化的查工具的敏感性和特异性的摘要.
主要成果:
- 常规查是有益的,并且似乎具有成本效益,以减少术后妄想.
- 常规查的成本效益比为2.89 (调整为2.34).
- 常规查比有针对性的查或常规干预更有优势.
结论:
- 常规的手术前查是一种有用且具有成本效益的策略,用于管理手术后妄想.
- 这种方法优于有针对性的查或通用干预策略.
- 进一步的研究可能将重点放在不断发展的查工具上,以加强实践.
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