认知功能和抑郁症对手术后痴呆风险的影响,在接受重大腹部手术的老年患者中
Gorkem Ozdemir1, Alper Sozutek
1Department of Gastroenterological Surgery, Adana City Training and Research Hospital, Adana, Turkey.
Medicine
|July 15, 2025
概括
手术后妄想 (POD) 是常见的老年患者在重大手术后. 较低的认知分数和较高的抑郁水平在手术前增加POD风险,迷你精神状态检查 (MMSE) 显示具有预测价值.
科学领域:
- 老年医学 老年医学
- 神经精神病学是一种神经精神病学.
- 外科手术的结果
背景情况:
- 手术后痴呆症 (POD) 是接受手术的老年患者经常出现的并发症.
- 大型腹部手术对老年人造成认知障碍和情绪变化的风险.
研究的目的:
- 研究术前认知功能,抑郁状态和老年患者POD发病率之间的关联.
- 在接受重大腹部手术的老年患者中确定POD的预测因素.
主要方法:
- 一项前性队列研究,涉及100名65岁以上的接受重大腹部手术的患者.
- 术前和术后的认知评估使用迷你精神状态检查 (MMSE),老年抑郁量表 (GDS) 和其他测试.
- 对人口统计数据和认知/抑郁测试结果进行统计分析,以确定POD的风险因素.
主要成果:
- 18%的患者发生了POD. 在术后观察到MMSE,GDS和时钟绘制测试得分的显著变化 (P < .001).
- 痴呆症组的患者在术后具有显著较低的GDS得分 (P = .021).
- 手术前MMSE得分的降低与POD风险增加密切相关 (OR:9.7;95%CI:1.3-71.4).
结论:
- 大型腹部手术可能会对认知功能产生负面影响,并增加老年患者的抑郁症.
- 在这种人群中,POD是一个显著的并发症,突出了需要进行风险评估的必要性.
- 在老年手术患者中,MMSE可以作为预测POD风险的宝贵工具.
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