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[髋关节手术后谵妄的发生率及危险因素]

[Incidence and risk factors of delirium after hip surgery].

作者信息

Bickel Horst, Gradinger Reiner, Kochs Eberhard, Wagner Klaus, Förstl Hans

机构信息

Klinik und Poliklinik für Psychiatrie und Psychotherapie der Technischen Universität München, Klinikum rechts der Isar.

出版信息

Psychiatr Prax. 2004 Oct;31(7):360-5. doi: 10.1055/s-2004-828361.

Abstract

OBJECTIVE

Postoperative delirium is common among elderly hip surgery patients. The objective of the current study was to determine the incidence of delirious states and to identify possible risk factors.

METHOD

The sample consisted of 200 consecutive patients, age 60 years and older, who underwent hip surgery because of acute hip fracture or elective hip replacement. Patients were prospectively assessed preoperatively and on a daily basis postoperatively using the Confusion Assessment Method (CAM). Associations between risk factors and delirium were analysed by means of multiple logistic regression models.

RESULTS

20.5 % of the sample were diagnosed with postoperative delirium. Statistically significant risk factors for the development of delirium were higher age, lower preoperative cognitive test performance and severe physical comorbidity. Some other putative risk factors tended to be associated with postoperative delirium, but failed to reach statistical significance.

CONCLUSIONS

The study confirmed a high incidence of delirium among hip surgery patients. Apart from established risk factors like old age, low cognitive test performance, and comorbidity, no other significant risk factors could be identified.

摘要

目的

术后谵妄在老年髋关节手术患者中很常见。本研究的目的是确定谵妄状态的发生率并识别可能的风险因素。

方法

样本包括200例连续的患者,年龄在60岁及以上,因急性髋部骨折或择期髋关节置换而接受髋关节手术。术前及术后每天使用谵妄评估方法(CAM)对患者进行前瞻性评估。通过多元逻辑回归模型分析风险因素与谵妄之间的关联。

结果

20.5%的样本被诊断为术后谵妄。谵妄发生的统计学显著风险因素为年龄较大、术前认知测试表现较差和严重的身体合并症。其他一些假定的风险因素倾向于与术后谵妄相关,但未达到统计学显著性。

结论

该研究证实髋关节手术患者中谵妄的发生率较高。除了年龄大、认知测试表现差和合并症等既定风险因素外,未发现其他显著的风险因素。

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