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髋部骨折全麻术后患者发生术后谵妄的危险因素:值得关注。

The risk factors of postoperative delirium in general anesthesia patients with hip fracture: Attention needed.

机构信息

Department of Emergency, The First Hospital of Jilin University, Changchun 130021.

Department of Emergency.

出版信息

Medicine (Baltimore). 2021 Jun 4;100(22):e26156. doi: 10.1097/MD.0000000000026156.

DOI:10.1097/MD.0000000000026156
PMID:34087873
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8183784/
Abstract

Delirium is a common postoperative complication of patients with hip fracture, yet the risk factors for postoperative delirium in patients with hip fracture remain unclear. We aimed to evaluate the associated risk factors of postoperative delirium in patients with hip fracture, to provide evidence for formulating coping measures of postoperative delirium prevention and treatment in clinical practice.Patients undergoing surgery for hip fracture from March 1, 2018 to September 30, 2020 in our hospital were included. The related characteristics and related lab examination results were reviewed and collected. The univariate and logistic regression analyses were performed to identify the potential risk factors.A total of 462 patients were included, the incidence of postoperative delirium in patients with hip fracture was 16.02%. Logistic regression analyses indicated that history of delirium (OR = 4.38, 1.15-9.53), diabetes mellitus (OR = 5.31, 1.23-10.75), hypoalbuminemia (OR = 4.97, 1.37-9.86), postoperative hypoxemia (OR = 5.67, 2.24-13.42), and body mass index (BMI) (kg/m2) (OR = 3.03, 1.36-6.18) were the independent risk factors for the delirium in patients with hip fracture surgery (all P < 0.05). The cutoff value of postoperative blood sugar, albumin, and BMI for delirium prediction was 8.05 (mmol/L), 32.26 (g/L), and 19.35 (kg/m2), respectively, and the area under curve of postoperative blood sugar, albumin, and BMI was 0.792, 0.714, and 0.703, respectively.Those patients with a history of delirium, postoperative hypoxemia, blood glucose ≥8.05 mmol/L, albumin ≤32.26 g/L, and BMI ≤19.35 kg/m2 particularly need the attention of healthcare providers for the prevention of delirium.

摘要

髋部骨折患者术后谵妄是一种常见的并发症,但髋部骨折患者术后谵妄的危险因素仍不清楚。我们旨在评估髋部骨折患者术后谵妄的相关危险因素,为临床实践制定术后谵妄防治对策提供依据。

纳入 2018 年 3 月 1 日至 2020 年 9 月 30 日在我院行手术治疗的髋部骨折患者,回顾性收集其相关特征及相关实验室检查结果。采用单因素及 Logistic 回归分析,识别潜在的危险因素。

共纳入 462 例患者,髋部骨折患者术后谵妄发生率为 16.02%。Logistic 回归分析显示,谵妄史(OR=4.38,1.15-9.53)、糖尿病(OR=5.31,1.23-10.75)、低白蛋白血症(OR=4.97,1.37-9.86)、术后低氧血症(OR=5.67,2.24-13.42)、体质量指数(BMI)(kg/m2)(OR=3.03,1.36-6.18)是髋部骨折术后发生谵妄的独立危险因素(均 P<0.05)。术后血糖、白蛋白、BMI 预测谵妄的截断值分别为 8.05 mmol/L、32.26 g/L、19.35 kg/m2,其曲线下面积分别为 0.792、0.714、0.703。

对于有谵妄史、术后低氧血症、血糖≥8.05 mmol/L、白蛋白≤32.26 g/L、BMI≤19.35 kg/m2的患者,尤其需要医护人员关注,以预防谵妄。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f270/8183784/c717b1f4e738/medi-100-e26156-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f270/8183784/c717b1f4e738/medi-100-e26156-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f270/8183784/c717b1f4e738/medi-100-e26156-g001.jpg

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