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英国老年患有术后痴呆症的老年患者的术后结果:SNAP-3,一个快照观察性研究

Helen A Blake¹, Claire J Swarbrick²,

¹University College London, London, UK.

British journal of anaesthesia

|February 26, 2026

概括

老年手术患者的手术后妄想是常见的,并显著增加住院时间,发病率和死亡率. 在手术决策中早期考虑妄想对于改善患者结果至关重要.

科学领域:

老年医学老年医学
手术结果研究研究.
衰老的神经科学衰老的神经科学

背景情况:

痴呆症影响大约6%的老年外科手术患者,在脆弱的个人或接受紧急手术的人群中发病率更高.
虽然与不良结果相关,但妄想与先前存在的脆弱性之间的因果作用仍在争论中.

研究的目的:

为了前性地研究术后狂妄症对老年手术患者结果的影响.
区分 Delirium 与潜在的患者因素对术后结果的影响.

主要方法:

对7128名60岁以上接受手术的英国患者进行前性观察队列研究.
使用4A测试或CAM-ICU进行术后第3和第7天的妄想评估.
采用量子和混合效应物流回归,使用DAG用于混和多重归算缺失的数据.

主要成果:

Delirium 发病率为 6.7%,与逗留时间中位数增加 5.2 天有关.
痴呆症患者的术后发病率 (aOR 10.2) 和120天死亡率 (aOR 1.8) 的几率明显更高.
痴呆症患者的一年死亡率也较高 (aOR 2.0),敏感性分析的结果一致.

结论:

手术后痴呆症是老年手术患者不良结果的重要独立预测因素.
痴呆症需要被纳入外科手术期间的共享决策中,对于考虑进行手术的患者.
强调妄想症的负面影响强调了有针对性的预防和管理策略的必要性.

关键词:

国家卫生服务 (NHS)年龄化的衰老.妄想妄想妄想妄想妄想流行病学流行病学脆弱脆弱脆弱脆弱脆弱老年医学老年医学在外科手术期间的护理.手术手术手术手术手术手术手术

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