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简要报告:老年手术患者术前衰弱与术后早期谵妄有关。

Brief report: preoperative frailty in older surgical patients is associated with early postoperative delirium.

机构信息

MPH, Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA 94143-0648, USA.

出版信息

Anesth Analg. 2011 May;112(5):1199-201. doi: 10.1213/ANE.0b013e31820c7c06. Epub 2011 Mar 3.

Abstract

We investigated whether preoperative frailty among older noncardiac surgical patients provides information about the development of postoperative delirium that is in addition to traditional geriatric risk factors. One-third of patients had a frailty score ≥3, which is considered "frail" in others' research. Twenty-five percent of patients developed postoperative delirium, which was measured using the confusion assessment method. Multivariable logistic regression showed that age, activities of daily living dependence, instrumental activities of daily living dependence, and cognitive functioning did not contribute significantly to the prediction of postoperative delirium. Only preoperative symptoms of depression (odds ratio=1.42; 95% confidence interval=1.06-1.91; P=0.018) and the frailty score (odds ratio=1.84; 95% confidence interval=1.07-3.1; P=0.028) were independently associated with the development of postoperative delirium.

摘要

我们研究了老年非心脏手术患者术前虚弱状况是否除了传统老年风险因素之外,还能提供关于术后谵妄发展的信息。三分之一的患者虚弱评分≥3,在其他研究中被认为是“虚弱”。25%的患者发生了术后谵妄,使用意识混乱评估方法进行了测量。多变量逻辑回归显示,年龄、日常生活活动依赖、工具性日常生活活动依赖和认知功能对术后谵妄的预测没有显著贡献。只有术前抑郁症状(比值比=1.42;95%置信区间=1.06-1.91;P=0.018)和虚弱评分(比值比=1.84;95%置信区间=1.07-3.1;P=0.028)与术后谵妄的发生独立相关。

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