Wang Lih, Seok Sangyun, Kim Sungsoo, Kim Kyungtaek, Lee Seunghyun, Lee Kyungho
Department of Orthopedic Surgery, Dong-A University Medical Center, Busan, The Republic of Korea.
Department of Orthopedic Surgery, Dong Eui Medical Center, Busan, The Republic of Korea.
J Knee Surg. 2017 Jul;30(6):600-605. doi: 10.1055/s-0036-1593872. Epub 2016 Nov 23.
We investigated the results of delirium which developed after total knee arthroplasty (TKA) and the risk factors for delirium in the patients who are older than 65 years. From March 2008 to March 2012, we performed a retrospective study on 296 knees of 265 patients who were treated with TKA. They were divided into two groups: 216 patients without delirium and 49 patients diagnosed with delirium by psychiatry. We analyzed the risk factors into three categories: First, the preoperative factors including gender, age, body mass index (BMI), clinical and functional knee joint score (Knee Society Knee Score and Knee Society Function Score) and the number of underlying diseases and associations with each disease; Second, the operative factors including the anesthesia method, amount of blood loss, operating time, laboratory factors, and transfusion count; Third, the postoperative factors such as start time of walking and duration of hospital stay were analyzed. There were significant statistical difference between two groups just in age, history of dementia, cerebrovascular disease, difference of hemoglobin and albumin, start time of walking, and duration of hospital stay. The delirium after TKA delays the postoperative ambulation and extends the hospital stay, which causes functional and socioeconomic loss of patients. Therefore, the risk factors for delirium should be assessed and proper prevention and management should be conducted.
我们调查了全膝关节置换术（TKA）后发生谵妄的结果以及65岁以上患者发生谵妄的危险因素。2008年3月至2012年3月，我们对265例行TKA治疗的患者的296个膝关节进行了回顾性研究。他们被分为两组：216例无谵妄患者和49例经精神科诊断为谵妄的患者。我们将危险因素分为三类：第一，术前因素，包括性别、年龄、体重指数（BMI）、临床和功能膝关节评分（膝关节协会膝关节评分和膝关节协会功能评分）以及基础疾病的数量和每种疾病的关联；第二，手术因素，包括麻醉方法、失血量、手术时间、实验室因素和输血次数；第三，分析术后因素，如开始行走的时间和住院时间。两组之间仅在年龄、痴呆病史、脑血管疾病、血红蛋白和白蛋白差异、开始行走的时间和住院时间方面存在显著统计学差异。TKA后的谵妄会延迟术后活动并延长住院时间，这会给患者带来功能和社会经济损失。因此，应评估谵妄的危险因素并进行适当的预防和管理。
