Matsuo Mitsuhiro, Yamagami Tohru
Department of Anesthesiology, Itoigawa General Hospital, 457-1 Takegahana, Itoigawa, Niigata, 941-8502, Japan.
Department of Orthopedic Surgery, Itoigawa General Hospital, Itoigawa, Niigata, Japan.
JA Clin Rep. 2019 Jun 14;5(1):39. doi: 10.1186/s40981-019-0259-5.
Serum cholinesterase (ChE) in elderly adults is associated with geriatric conditions such as sarcopenia and malnutrition. The aim of this study is to examine the impact of preoperative serum ChE on the development of complications after noncardiac surgery in elderly patients without liver cirrhosis.
We retrospectively identified all patients aged ≥ 65 years who underwent orthopedic surgery over a 1.5-year period in our hospital. The main outcome was postoperative complications, defined as a deviation from the normal postoperative course within 30 days postoperatively.
A total of 313 patients (median age 79 years) were included. The incidence of all-cause postoperative complications was 15.7% (49/313 patients). Receiver operating characteristic curve analysis showed that serum ChE was a univariable factor that predicted all-cause complications with moderate accuracy (area under the curve = 0.694, 95% confidence interval (CI) 0.604-0.783), with an optimal serum ChE cutoff level of 200 units/L. After multivariate analyses adjusted by baseline characteristics, low serum ChE remained a significant risk factor for postoperative complications (odds ratio = 2.99, 95% CI 1.41-6.33, P = 0.004).
Low serum ChE (< 200 unit/L) is a significant risk factor for postoperative complications after orthopedic surgery in patients aged ≥ 65 years.
老年人血清胆碱酯酶（ChE）与肌肉减少症和营养不良等老年疾病有关。本研究旨在探讨术前血清ChE对无肝硬化老年患者非心脏手术后并发症发生的影响。
我们回顾性纳入了我院1.5年内接受骨科手术的所有年龄≥65岁的患者。主要结局是术后并发症，定义为术后30天内术后正常病程的偏离。
共纳入313例患者（中位年龄79岁）。全因术后并发症发生率为15.7%（49/313例患者）。受试者工作特征曲线分析显示，血清ChE是预测全因并发症的单因素，准确性中等（曲线下面积=0.694，95%置信区间（CI）0.604-0.783），血清ChE最佳截断水平为200单位/L。在根据基线特征进行多因素分析后，低血清ChE仍然是术后并发症的显著危险因素（比值比=2.99，95%CI 1.41-6.33，P=0.004）。
血清ChE低（<200单位/L）是≥65岁患者骨科手术后术后并发症的显著危险因素。
