术后流血是老年人骨折患者术后狂妄的危险因素:一项回顾性研究
Yubo Deng1, Tianqin Zhang1, Hu Xie1
1The Second People's Hospital of China Three Gorges University, Yichang, China.
Frontiers in medicine
|August 11, 2025
概括
在老年关节骨折患者中,术后失血是术后狂妄 (POD) 的重要危险因素. 减少手术内流血和手术持续时间可能有助于预防POD.
科学领域:
- 老年医学 老年医学
- 神经外科 神经外科
- 麻醉学 麻醉学
背景情况:
- 手术后痴呆症 (POD) 是接受关节骨折手术的老年患者的常见和严重并发症.
- POD与增加的发病率和死亡率有关,强调需要确定其危险因素.
研究的目的:
- 调查老年关节骨折患者的外科手术期间流血和术后狂妄的发生率之间的关联.
- 在这个脆弱的患者群体中确定POD可修改的风险因素.
主要方法:
- 使用247名关节骨折患者的电子病历进行了一项回顾性队列研究.
- 使用基于DSM-5标准的混评估方法 (CAM) 诊断术后妄想.
- 使用粗线性方程量化了外科手术期间的血液损失,后勤回归分析确定了风险因素.
主要成果:
- POD的发生率为39.7%.
- 增加的手术内流血 (OR:6.017) 和延长的手术时间 (OR:1.072) 是POD的独立风险因素.
- 在血液损失和POD易感性之间观察到剂量反应关系.
结论:
- 在老年关节骨折患者中,外科手术期间的失血是POD的重要和可修改的风险因素.
- 建议采取尽量减少手术期间流血和手术时间的策略,以减少POD的发生率.
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