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肝切除术后患者术后谵妄的发生率及危险因素

Incidence and Risk Factors for Postoperative Delirium in Patients After Hepatectomy.

作者信息

Park Sung Ae, Tomimaru Yoshito, Shibata Asuka, Miyagawa Shinichi, Noguchi Kozo, Dono Keizo

机构信息

Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara, Toyonaka, Osaka, 560-8565, Japan.

Department of Psychiatry, Toyonaka Municipal Hospital, 4-14-1 Shibahara, Toyonaka, Osaka, 560-8565, Japan.

出版信息

World J Surg. 2017 Nov;41(11):2847-2853. doi: 10.1007/s00268-017-4079-3.

Abstract

BACKGROUNDS

Postoperative delirium is a common complication after surgery. However, the incidence and risk factors associated with delirium after liver resection have not been clarified. Thus, this study aimed to investigate the incidence and risk factors for delirium in patients that underwent liver resections.

METHODS

This study included 196 consecutive patients that underwent a liver resection. Groups with and without delirium were compared to identify differential patient characteristics. Multivariate regression analysis was used to identify independent factors that significantly influenced the development of postoperative delirium.

RESULTS

Postoperative delirium developed in 44 (22.4%) of the 196 patients. Majority of incidents occurred on postoperative day 2, and mean duration was 4.2 ± 5.5 days. Patients with delirium exhibited the following features: advanced age, low serum albumin levels, a high probability of a positive test for anti-hepatitis C virus antibody, cerebrovascular disorders, cardiovascular diseases, diabetes mellitus, use of benzodiazepines, and previous history of delirium. Multivariate analysis revealed that the delirium development was significantly correlated with age, serum albumin level, presence of cerebrovascular disorder, use of benzodiazepines, and a previous history of delirium.

CONCLUSIONS

This study clarified the incidence and risk factors for delirium after liver resection. These results would contribute to prediction and treatment of delirium.

摘要

背景

术后谵妄是手术后常见的并发症。然而,肝切除术后谵妄的发生率及相关危险因素尚未明确。因此,本研究旨在调查接受肝切除患者谵妄的发生率及危险因素。

方法

本研究纳入196例连续接受肝切除的患者。比较发生谵妄和未发生谵妄的两组患者,以确定不同的患者特征。采用多因素回归分析确定对术后谵妄发生有显著影响的独立因素。

结果

196例患者中有44例(22.4%)发生术后谵妄。大多数事件发生在术后第2天,平均持续时间为4.2±5.5天。发生谵妄的患者具有以下特征:高龄、血清白蛋白水平低、抗丙型肝炎病毒抗体检测呈阳性的可能性高、脑血管疾病、心血管疾病、糖尿病、使用苯二氮䓬类药物以及既往有谵妄病史。多因素分析显示,谵妄的发生与年龄、血清白蛋白水平、脑血管疾病的存在、苯二氮䓬类药物的使用以及既往有谵妄病史显著相关。

结论

本研究明确了肝切除术后谵妄的发生率及危险因素。这些结果将有助于谵妄的预测和治疗。

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