术后妄想和虚弱对脊柱手术30天结果的补充效应
Nithin K Gupta1, Stefan T Prvulovic2, Sina Zoghi3
1Campbell University School of Osteopathic Medicine, Lillington, NC, USA; Bowers Neurosurgical Frailty and Outcomes Data Science Lab, Sandy, UT, USA.
The spine journal : official journal of the North American Spine Society
|December 14, 2024
概括
经过脊柱手术的脆弱老年患者患上术后妄想症 (POD) 的风险更高,这显著增加了死亡率和发病率. 使用风险分析指数 (RAI) 识别脆弱性可以帮助减轻这些风险.
科学领域:
- 老年人手术是一门老年手术.
- 神经外科 神经外科
- 整形外科手术 整形外科手术
背景情况:
- 全球人口老龄化正在推动脊柱外科手术因退行性疾病而增加.
- 老年患者,特别是那些脆弱的患者,在脊椎手术后面临着术后妄 (POD) 的高风险.
- 在这个脆弱的患者群体中,POD与术后发病率和死亡率的增加有关.
研究的目的:
- 在接受脊椎手术的患者中调查脆弱性和POD之间的关联.
- 确定POD对脆弱脊椎手术患者非致命和致命不良结果的影响.
主要方法:
- 使用2021年美国外科医生学院国家外科质量改进计划 (NSQIP) 数据库进行回顾性队列研究.
- 分析包括4,195名75岁及以上的患者,他们接受了脊椎手术.
- 使用风险分析指数 (RAI) 评估脆弱性;结果包括POD,30天死亡率和非致命不良事件. 统计分析涉及多变量逻辑回归和调解分析.
主要成果:
- 在研究的4195名患者中,术后痴呆症 (POD) 在8.4%的患者中被发现.
- 较高的风险分析指数 (RAI) 评分,表明更大的脆弱性,与POD显著相关 (p<.001).
- POD独立地与30天死亡率和非致命不良结果 (p<.001) 的增加有关,在脆弱性和POD之间观察到对死亡率的协同效应.
结论:
- 通过RAI测量的脆弱性和POD都是经过脊柱手术的老年人死亡率和发病率的独立预测因素.
- POD加剧了脆弱的负面影响,突出了它在不利结果中的作用.
- 该RAI可以识别患有POD风险的脆弱患者,从而实现针对性干预,如预康复或专门的术后护理,以改善手术结果.
更多相关视频
08:17A Mouse Model of Orthopedic Surgery to Study Postoperative Cognitive Dysfunction and Tissue Regeneration
Published on: February 27, 2018
16.3K
04:19Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
Published on: November 8, 2024
355
相关概念视频
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
48
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
48
01:21Skeletal Muscle Relaxants: Adverse Effects
335
Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
Unlike...
335