整体关节整形术后的术后妄:流行病学,危险因素和相关并发症
Ashley Knebel1, Manjot Singh1, Rhea Rasquinha1
1Warren Alpert Medical School, Brown University, Providence, RI, USA.
概括
在全关节关节整形术患者中,术后狂妄症 (POD) 很少见,但很严重,特别是在有认知问题的老年人中. 虽然发病率有所下降,但警和预防策略对于改善患者的治疗结果至关重要.
科学领域:
- 整形外科手术 整形外科手术
- 老年医学 老年医学
- 神经科学是一个神经科学.
背景情况:
- 手术后痴呆症 (POD) 对接受重大手术的老年患者,特别是全关节整形术 (TKA,THA) 来说是一个重大问题.
- 了解POD的风险因素和后果对于改善患者护理和治疗结果至关重要.
研究的目的:
- 在接受TKA或THA的患者中调查POD的发病率,趋势和风险因素.
- 为了分析90天的术后并发症和与POD相关的成本在这个患者群体中.
主要方法:
- 使用PearlDiver数据库 (2010-2022) 对TKA和THA患者的回顾性分析.
- 在手术后7天内,患者被分为有POD和没有POD的队列.
- 进行了流行病学,人口学和并发症分析,包括对电解质干扰和90天后的并发症进行了匹配比较.
主要成果:
- 整体POD发病率为0.3% (7,240/2,518,918名患者),从2010年的0.54%下降到2022年的0.10%.
- 在老年患者和具有基线认知障碍的患者中,POD的患病率更高,特别是在修复手术期间.
- POD患者经历了更高的90天费用和医疗,手术和关节相关并发症的增加率,包括电解质障碍,如高血和低血.
结论:
- 尽管下降趋势,POD仍然是一个关节整形术后的关键并发症,特别是在先前存在认知障碍的老年患者中.
- POD与医疗保健成本显著增加以及不良术后结果的风险更高有关.
- 持续关注全关节形术中POD预防策略是必不可少的,以减轻其对患者发病率和医疗保健资源利用的影响.
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