在接受心脏手术的老年患者中预测术后妄想风险的实用预后工具:视觉和动态名ograms
Chernor Sulaiman Bah1,2, Bongani Mbambara1,2, Xianhai Xie3
1School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China.
Journal of clinical monitoring and computing
|September 21, 2024
概括
这项研究开发了两种名图,用于预测老年心脏手术患者的术后痴呆 (POD) 风险. 这些工具有助于制定早期干预策略,以改善患者的治疗结果.
科学领域:
- 老年医学 老年医学
- 心脏病学 心脏病学
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
背景情况:
- 手术后妄想 (POD) 影响到65%的老年人心脏手术后,增加发病率和死亡率.
- 预测工具对于及时干预以减轻POD风险至关重要.
研究的目的:
- 开发和验证两种动态名录模型,用于预测心脏手术中老年患者的POD风险.
- 确定POD的关键术前和术后预测因子.
主要方法:
- 对531名接受心脏手术的老年患者进行了回顾性队列研究.
- 后勤回归分析,以确定模型开发的重要预测因素.
- 模型性能使用ROC曲线,十倍交叉验证和DCA进行评估.
主要成果:
- 在30%的患者中发生POD.
- 术前预测因素包括ASA,脑血管疾病,Alb和URE.
- 术后预测因素包括ASA,MMSE,URE,CPB持续时间和APACHE II.
- 模型表现出令人满意的预测性能,AUC为0.731 (手术前) 和0.799 (术后).
- 基于Web的计算器可供临床使用.
结论:
- 为了预测在手术前和手术后阶段的POD风险,建立了两个动态诺莫格拉姆模型.
- 这些模型可以指导在不同时间点实施干预措施.
- 经过验证的模型为心脏手术患者的POD风险分层和管理提供了有价值的工具.
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