手术后妄想:国家外科质量改善计划中预测因素,并发症和查模式的回顾性研究
Adriana C Panayi1,2, Sarah Friedrich3, Jasmin Rühl3
1Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Oral and Maxillofacial Surgery, Berlin, Germany.
EClinicalMedicine
|January 7, 2026
概括
手术后痴呆症显著增加了手术患者的死亡率和并发症. 常规查至关重要,因为当前的做法不充分认识到这种情况,特别是在老年人中.
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:
- 手术后妄是一种严重的并发症,影响手术患者的发病率,死亡率和长期认知能力.
- 目前的妄想预测方法不准确,导致不一致的查实践.
研究的目的:
- 分析手术后痴呆症的发病率和预测因素在一个大型的手术队列中.
- 评估 Delirium 与外科手术不良结果的关联.
- 评估国家外科手术数据库中的查实践和差异.
主要方法:
- 从2021-2023年ACS-NSQIP数据库中对217,783名成年外科病人的回顾性分析.
- 患者被分为妄症,非妄症或未查组.
- 多变量回归模型确定了与妄想相关的预测因素和结果.
主要成果:
- 痴呆症发生在10.6%的查患者中 (年龄≥75岁).
- 痴呆症独立地与30天死亡率增加 (OR 3.2),重新手术 (OR 2.3),手术并发症 (OR 1.8) 和功能衰退 (OR 1.6) 相关.
- 查仅限于老年人,在老年年龄组的病率较低,阳性比例较高.
结论:
- 手术后痴呆症是不良外科手术结果的独立预测因素.
- 目前的查实践不足,并且在各个患者群体之间存在差异.
- 标准化查和有针对性的预防对于改善术后护理至关重要.
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