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术前维生素D缺乏和术后妄想风险:多中心回顾性研究

Kuo-Chuan Hung^1,2, Ting-Sian Yu³, Shu-Wei Liao^1,4

¹Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.

Frontiers in nutrition

|August 1, 2025

概括

术前维生素D缺乏症 (VDD) 在接受肌肉骨手术的患者中显著增加了术后妄想症 (POD) 的风险. 解决VDD可能会改善手术结果.

科学领域:

整形外科整形外科整形外科
内分泌学在内分泌学.
老年病的医生老年病的医生

背景情况:

手术后痴呆症 (POD) 是手术患者的常见并发症.
维生素D缺乏 (VDD) 很普遍,可能会影响手术结果.
在肌肉骨外科手术中,术前VDD和POD风险之间的关系需要研究.

研究的目的:

评估手术前维生素D水平与POD发生率之间的关联.
在手术患者中确定与VDD相关的二次结果.
在VDD患者中探索POD的风险因素.

主要方法:

一项使用TrinetX数据库的回顾性队列研究.
包括50岁以上接受肌肉骨手术的患者.
将患者分为维生素D缺乏 (≤20 ng/mL),不足 (21-29 ng/mL) 和充足 (≥30 ng/mL) 的组.
主要结局:POD在30天内;次要结局:手术部位感染,急救诊所访问,ICU入院.
用于风险因素分析的多变量逻辑回归.

主要成果:

维生素D缺乏 (VDD) 与POD风险显著增加有关 (OR: 2.18,p < 0.001).
在VDD患者中,ED访问率增加 (OR: 1.36,p < 0.001) 和ICU入院率增加 (OR: 1.51,p < 0.001).
维生素D缺乏症也显著增加了妄想风险 (OR: 1.49,p = 0.023) 和其他不良事件,这表明了剂量依赖的关系.
高龄,男性性别,慢性病和营养不良预测了VDD患者的POD.

结论:

手术前的维生素D缺乏与术后狂妄症的风险增加有关.
在手术前对维生素D进行查和补充可能会改善患者的治疗结果.
需要进一步的前性研究来确认因果关系和治疗疗效.

关键词:

认知功能障碍认知功能障碍肌肉骨外科手术肌肉骨手术在外科手术期间的危险因素.在手术后出现妄症.倾向性得分匹配的比分匹配维生素D缺乏症维生素D缺乏症

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