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老年人的术后妄想:一个回顾性队列研究

J A Vélez-Restrepo¹, P A Betancourt-Ángel², J D Caicedo-Jaramillo¹

¹Departamento de Anestesiología, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.

Revista espanola de anestesiologia y reanimacion

|June 7, 2025

概括

手术后妄 (POD) 影响了60岁以上的手术患者的6.0%,特别是那些患有先前存在的疾病或正在接受紧急手术的人. 这种情况增加了术后并发症和住院死亡的风险.

科学领域:

在外科手术期间的医学.
老年医学老年医学
麻醉学麻醉学

背景情况:

手术后痴呆症 (POD) 是老年手术患者的重大不良事件,与较高的发病率,死亡率和成本有关.
由于缺乏诊断和预防方案,哥伦比亚的POD报告不足.
识别POD发病率和风险因素对于改善患者的治疗结果至关重要.

研究的目的:

为了确定60岁以上接受手术的患者中POD的发病率.
识别与POD发展相关的潜在风险因素.
调查POD和其他术后并发症之间的关联.

主要方法:

对2535名60岁以上的患者进行了回顾性队列研究,这些患者在2012年至2019年期间接受了手术.
使用随机抽样分析电子病历.
在手术后7天内评估POD发生率,危险因素和并发症.

主要成果:

POD的累积发病率为6.0% (95% CI:5.1%-6.9%),其中67%发生在前3个术后天.
关键风险因素包括精神疾病,手术前使用阿片类药物,ASA类III/IV,血管手术,紧急/紧急手术和功能依赖.
POD与增加的住院死亡率显著相关 (OR 2.9; 95% CI 1.66-5.07).

结论:

POD是老年手术患者的常见并发症,特别是那些接受紧急/紧急或血管手术的人.
具有特定风险因素 (精神病史,功能依赖,ASA类>III) 的患者更容易患POD.
POD与术后发病率和死亡率的增加有关,这突显了针对性预防和管理策略的需要.

关键词:

年龄较大的成年人.麻醉麻醉是一种麻醉.麻醉麻醉麻醉麻醉麻醉疯狂的 Delirio 是一个很好的方法.经过手术后的 Delirio postoperatorio 这种精神错乱.狂妄症是什么意思狂妄症是什么意思神经认知障碍神经认知障碍年龄较大的成年人.手术后的时间手术后的时间手术后妄症术后妄症手术后的时间术后期神经认知障碍 (Trastornos neurocognitivos) 是一种神经认知障碍.

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