临床表现 临床表现
Eric Ka J Cheuk1,2, Ellene Yan1,2, Yasmin Alhamdah1
1Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 24, 2025
概括
在老年手术患者中,认知障碍 (CI) 和虚弱是常见的,CI患者的虚弱患病率较高. 早期发现这两种情况是改善手术恢复和结果的关键.
科学领域:
- 老年医学 老年医学
- 麻醉学 麻醉学
- 认知神经学 认知神经学
背景情况:
- 认知障碍 (CI) 和虚弱增加了手术的脆弱性.
- 了解CI患者的脆弱性轨迹对于外科手术期间的护理至关重要.
- 这项研究调查了老年手术患者的虚弱患病率,预测因素和结果,包括具有或没有CI的老年手术患者.
研究的目的:
- 在手术后的CI和无CI患者中比较虚弱的患病率和发展轨迹.
- 确定与手术前虚弱相关的以患者为中心的变量.
- 根据基线脆弱性水平检查临床结果.
主要方法:
- 使用AD8,Mini-Cog和MoCA在接受选择性非心脏手术的≥65岁患者中评估了手术前的认知障碍 (CI).
- 使用5项FRAIL问卷在手术前和30日和90日测量脆弱性.
- 采用了对变量关联的逻辑回归,并从电子病历中收集了临床结果.
主要成果:
- 根据评估工具,CI的患病率有所不同 (AD8: 13.6%,Mini-Cog: 12.6%,MoCA: 34.1%).
- 在所有时间点 (AD8,MoCA) 中,CI患者表现出明显更高的脆弱性.
- 在CI和非CI组中,脆弱性同样有所改善;女性,骨科手术,功能障碍和OSA风险预测了手术前脆弱性.
- 虚弱和虚弱前的患者经历了较高的非家庭出院率,并发症和不良结果.
结论:
- 在CI患者中观察到较高的脆弱性患病率,导致术后结果较差.
- 早期发现虚弱和CI对于个性化外科手术期间管理至关重要.
- 量身定制的策略可以增强康复和优化以患者为中心的护理和临床结果.
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