经过导管大动脉置换后的 Delirium:发生率,预测因素,以及1年的功能和认知结果
Gabriele Melegari1, Michele Villa2, Martino Regazzi3
1Department of Anaesthesia and Intensive Care, Azienda Ospedaliero Universitaria Policlinico di Modena, Modena, Italy.
Journal of cardiothoracic and vascular anesthesia
|March 1, 2026
概括
手术后痴呆症 (POD) 影响21.9%的患者经过过导管大动脉置换 (TAVR). 识别低基线认知等风险因素对于预防功能恢复不良和死亡率增加至关重要.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 神经学 神经学
背景情况:
- 过导管大动脉置换 (TAVR) 是对大动脉狭窄的日益增长的手术.
- 手术后痴呆症 (POD) 是一种常见的并发症,影响患者的治疗结果.
- 了解TAVR后的POD发病率和风险因素对于改善患者护理至关重要.
研究的目的:
- 为了确定TAVR后的POD发病率.
- 为了确定TAVR患者中POD的倾向性风险因素.
- 评估POD对TAVR后3个月和1年的认知和功能结果的影响.
主要方法:
- 对201名接受TAVR的老年患者进行前性观察队列研究.
- 使用CAM/CAM-ICU进行妄想查的标准化外科护理.
- 使用MMSE,HADS和巴特尔指数评估认知和功能状态.
主要成果:
- POD的发生率为21.9%.
- POD的独立预测因素包括较低的基线迷你精神状态检查 (MMSE) 评分,高白细胞计数和非关接入.
- POD与长时间住院,功能恢复受损和1年死亡率增加有关.
结论:
- POD是TAVR后的一个显著并发症,特别是在患有先前存在的认知障碍或接受非关节TAVR的患者中.
- 术前认知评估对于识别高风险个体至关重要.
- 需要针对这一易受伤害的TAVR群体的POD制定有针对性的预防策略,以减轻不良结果.
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