将注意力功能登记作为谵妄发生的预测指标（RAPID研究）。
Registration of attentional function as a predictor of incident delirium (the RAPID study).
作者信息
van Zuylen Mark L, Hermanides Jeroen, Ten Hoope Werner, Preckel Benedikt, van de Beek Diederik, van Gool Willem A, Schoenmaker Niels
机构信息
Department of Anesthesiology Amsterdam UMC University of Amsterdam Amsterdam the Netherlands.
Department of Anesthesiology Rijnstate Hospital Arnhem the Netherlands.
出版信息
Alzheimers Dement (N Y). 2020 Jun 16;6(1):e12031. doi: 10.1002/trc2.12031. eCollection 2020.
INTRODUCTION
Older adults undergoing elective surgery have a high risk of developing postoperative delirium (POD). Validated models predicting POD are scarce. This study investigated whether preoperative impairment of attentional function predicts POD in older adults without previously diagnosed cognitive impairment.
METHODS
In this prospective cohort study we recruited patients aged ≥70 years preceding major elective surgery. Preoperatively a visual vigilance test was administered to determine intra-individual reaction-time variability. Postoperatively, presence of delirium was screened daily.
RESULTS
We recruited 152 patients, 25 (16.4%) developed POD. Intra-individual reaction-time variability was not significantly different between patients with or without POD (0.18 ± 0.08 ms vs 0.22 ± 0.11 ms; = 0.087). Receiver operating characteristic analyses indicated a poor accuracy for POD (area under the curve 0.609 ± 0.63). Except for surgery duration, no clinically significant between-group differences were found for secondary outcome parameters.
DISCUSSION
Preoperative intra-individual reaction time variability does not predict the incidence of POD in older patients undergoing major elective surgery.
引言
接受择期手术的老年人发生术后谵妄（POD）的风险很高。预测POD的有效模型很少。本研究调查了术前注意力功能受损是否能预测未被诊断为认知障碍的老年人发生POD的情况。
方法
在这项前瞻性队列研究中，我们招募了在进行大型择期手术前年龄≥70岁的患者。术前进行了视觉警觉测试，以确定个体内反应时间变异性。术后每天筛查谵妄的发生情况。
结果
我们招募了152名患者，其中25名（16.4%）发生了POD。发生POD和未发生POD的患者之间个体内反应时间变异性无显著差异（0.18±0.08毫秒对0.22±0.11毫秒；P=0.087）。受试者工作特征分析表明，POD的预测准确性较差（曲线下面积为0.609±0.63）。除手术持续时间外，次要结局参数在组间未发现具有临床意义的差异。
讨论
术前个体内反应时间变异性不能预测接受大型择期手术的老年患者发生POD的发生率。
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