在接受非心脏手术的老年人中出现手术后痴呆症
Heather L Lander1, Andrew W Dick2, Karen E Joynt Maddox3,4
1Department of Anesthesiology and Perioperative Medicine, University of Rochester School of Medicine, Rochester, New York.
在接受非心脏手术的老年人中,术后妄想显著增加了3.5倍的死亡或重大并发症的风险. 痴呆率在医院有相当大的差异,强调它是改善外科手术前大脑健康的目标.
科学领域:
- 老年医学 老年医学
- 外科手术的结果
- 神经科学是一个神经科学.
背景情况:
- 手术后妄 (POD) 是接受手术的老年人常见的并发症.
- 了解POD与不良结果和医院变异的关联对于改善外科手术前大脑健康至关重要.
研究的目的:
- 调查POD与30天死亡率和并发症之间的联系.
- 评估POD发病率在医院一级的变化.
主要方法:
- 在美国医院 (2017-2020年) 进行了超过550万次因重大非心脏手术住院的回顾性队列研究.
- 使用多变量和多层物流回归分析来检查关联和变异.
主要成果:
- POD的发生率为3.6%.
- 患有POD的患者死亡或重大并发症的几率显著增加 (aOR 3.47),30天死亡率 (aOR 2.77) 和非家庭出院 (aOR 3.96).
- 观察到POD率在医院水平上有显著的变化,即使对患者风险进行了调整.
结论:
- 在老年手术患者中,POD与死亡率,并发症和非家庭出院的增加密切相关.
- 在POD率的实质性医院变化表明,它是改善外科手术期间护理和大脑健康的可修改目标.
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