术前预后营养指数作为预测术后狂妄症的有用工具,用于老年患者患有退行性腰部疾病
Jinlei Zhou1, Jing Tang2, Shanggao Xie1
1Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, People's Republic of China.
Therapeutics and clinical risk management
|June 12, 2025
概括
手术后妄想 (POD) 在腰椎手术后很常见. 手术前的预后营养指数 (PNI) 可以预测经过跨腰间体融合 (TLIF) 的老年患者的POD风险.
科学领域:
- 神经外科 神经外科
- 老年病的医生 老年病的医生
- 临界护理医学 临界护理医学
背景情况:
- 手术后妄 (POD) 是腰椎手术后的常见并发症,阻碍了患者的康复.
- 识别POD的风险因素对于改善经过脊髓融合的老年患者的治疗结果至关重要.
研究的目的:
- 这项研究调查了预后营养指数 (PNI) 作为POD的预测因子,该指数可用于接受转腰椎体间融合 (TLIF) 的老年患者.
主要方法:
- 对370名在2020-2024年间接受TLIF治疗的老年患者进行了回顾性分析.
- 诊断POD是基于混评估方法. 手术前的PNI是根据血清白蛋白和淋巴细胞计数计算的.
- 多变量物流回归和ROC曲线分析确定了PNI对POD的预测值.
主要成果:
- 在61名患者中发生POD;下部PNI与妄想有关.
- 低PNI (OR:0.743),低白蛋白 (OR:0.759) 和晚年 (OR:1.096) 是独立的POD预测因素.
- PNI的AUC为0.864,截止值为45.825 (灵敏度为82.0%,特异性为74.4%).
结论:
- 术前PNI是评估TLIF接受TLIF的老年患者POD风险的有希望的工具.
- 这一指数可以帮助分层患者,并实施有针对性的干预措施来预防妄想.
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