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在接受非心脏手术的老年患者中,多种疾病模式与术后妄想有关:一项观察性研究
Xiao-Yi Hu1,2, Di Fan2, Xue-Yan Guo2
1Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Frontiers in medicine
|March 4, 2026
概括
在老年手术患者中,明显的多病态模式与术后妄想 (POD) 风险有关. 脆弱性部分介导高风险子组对POD的影响,有助于手术前风险分层.
科学领域:
- 老年人手术是一门老年手术.
- 临床流行病学临床流行病学
- 患者的治疗结果.
背景情况:
- 在老年手术患者中,多病症很常见,并且与糟糕的治疗结果有关.
- 多重病态模式对术后妄想 (POD) 的具体影响尚不清楚.
- 这项研究调查了不同多病态模式与POD发病率之间的关联.
研究的目的:
- 在老年成人手术患者中识别不同的多病症子组.
- 检查这些子组,脆弱性和认知表现之间的关系.
- 确定特定的多病症模式是否预测术后妄想风险.
主要方法:
- 隐性类别分析用于将819名老年成人手术患者根据疾病组成分为子组.
- 调解效应分析探讨了虚弱 (埃德蒙顿虚弱量表) 和认知表现 (MMSE) 在子组-POD关系中的作用.
- 多位数逻辑回归模型预测了子组成员资格,评估了AUROC和AUPRC的预测准确性.
主要成果:
- 确定了三个不同的多病症子组,显示了脆弱性和认知功能的显著差异 (p < 0.05).
- 小组2与POD风险增加有关,脆弱性部分介导了这一效应 (间接效应=0.043).
- 多位数逻辑回归模型对子组成员的预测准确度很高 (AUROC>0.97,AUPRC>0.88对所有子组).
结论:
- 一种特定的多病症模式显著增加了老年手术患者的POD风险,通过虚弱介导.
- 确定的子组及其与POD风险的关联为临床实践提供了宝贵的见解.
- 多项逻辑回归为基于多病态模式的术前风险分层提供了一个强大的工具.
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