在接受非心脏手术的老年患者中,术前贫血和术后狂妄之间存在关联:一项追溯观察性研究
Ah Ran Oh1, Jungchan Park1, Chung Soo Kim1
1Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean journal of anesthesiology
|April 7, 2025
概括
在接受非心脏手术的老年患者中,手术前的贫血显著增加了术后狂妄 (POD) 的风险. 这种关联随着贫血的严重程度而增强,突出了潜在的可修改的危险因素.
科学领域:
- 老年医学 老年医学
- 麻醉学 麻醉学
- 外科手术的结果
背景情况:
- 在非心脏手术后的老年患者中,术前贫血和术后妄 (POD) 之间的关系尚不清楚.
- 研究这种关联对于了解老年人群中术后风险至关重要.
研究的目的:
- 评估手术前贫血对非心脏手术的老年患者POD发病率的影响.
- 评估贫血严重程度和POD风险之间的剂量反应关系.
主要方法:
- 对62600名接受非心脏手术的老年患者 (≥60岁) 的回顾性分析.
- 根据手术前贫血状况 (血红蛋白<13 g/L男性,<12 g/dL女性) 和严重程度 (轻度或中度至重度) 分类的患者.
- 治疗权重的反向概率 (IPTW) 用于控制混因素.
主要成果:
- 在7天内POD的总体发病率为3.9%.
- 在IPTW后,术前贫血与POD风险增加显著相关 (OR,1.42;P < 0.001).
- 贫血的严重程度与POD风险相关:轻度贫血 (OR,1.32;P < 0.001) 和中度至重度贫血 (OR,1.70;P < 0.001).
结论:
- 术前贫血是非心脏手术后老年患者POD的重要危险因素.
- 随着贫血严重程度的增加,POD的风险会升级.
- 需要进一步的研究来确定手术前贫血是否是POD的可修改风险因素.
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