老年心脏手术后精神障碍的发生率及后果——与年轻患者的比较
The incidence and consequences of mental disturbances in elderly patients post cardiac surgery--a comparison with younger patients.
作者信息
Heijmeriks J A, Dassen W, Prenger K, Wellens H J
机构信息
Department of Cardiology, Academic Hospital, Maastricht, The Netherlands.
出版信息
Clin Cardiol. 2000 Jul;23(7):540-6. doi: 10.1002/clc.4960230714.
BACKGROUND
Limited data exist about the incidence and consequences of mental confusion following open heart surgery in different age groups. Likewise, little is known about preoperative predictors of mental confusion.
METHODS
Two-hundred consecutive patients, aged > or =75 years (Group 1), and 400 procedure- and gender-matched younger patients (Group 2) who underwent coronary or valvular surgery were included in a prospective study. The relation between postoperative mental confusion, mortality, morbidity, and quality of life was studied.
RESULTS
Mental confusion was present in 11.8% Group 2 and 22.6% Group 1 patients. The incidence was higher after valvular surgery. Preoperative risk factors in Group 1 patients were diabetes mellitus, a history of heart failure, weak carotid pulsations, and repeat surgery. Late mortality, after a median follow-up duration of 31 months, was significantly worse in patients who were confused, which was related to the underlying disease. Recovery of quality of life was clearly diminished in elderly patients with confusion in contrast to younger patients.
CONCLUSION
Postoperative mental confusion has a high incidence in the elderly population and is associated with a diminished quality of life.
背景
关于不同年龄组心脏直视手术后精神错乱的发生率及后果的数据有限。同样，对于精神错乱的术前预测因素也知之甚少。
方法
一项前瞻性研究纳入了200例年龄≥75岁的连续患者（第1组）以及400例在手术和性别上与之匹配的年轻患者（第2组），这些患者均接受了冠状动脉或瓣膜手术。研究了术后精神错乱与死亡率、发病率及生活质量之间的关系。
结果
第2组患者中11.8%出现精神错乱，第1组患者中22.6%出现精神错乱。瓣膜手术后发病率更高。第1组患者的术前危险因素为糖尿病、心力衰竭病史、颈动脉搏动微弱及再次手术。在中位随访期31个月后，精神错乱患者的晚期死亡率明显更差，这与基础疾病有关。与年轻患者相比，老年精神错乱患者的生活质量恢复明显受损。
结论
术后精神错乱在老年人群中发病率较高，且与生活质量下降相关。
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