老年头颈部大手术患者的认知障碍和谵妄。
Cognitive Impairment and Delirium in Older Patients Undergoing Major Head and Neck Surgery.
机构信息
Departments of Otolaryngology-Head and Neck Surgery and Surgical Oncology, Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada.
Department of Biostatistics, Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada.
出版信息
Otolaryngol Head Neck Surg. 2022 Jul;167(1):97-99. doi: 10.1177/01945998211045293. Epub 2021 Sep 21.
The study objective was to measure the prevalence and predictors of cognitive impairment (CI) and delirium. Adults undergoing major head and neck cancer surgery completed the Clock Draw Test to screen for CI, defined as a score of 0 or 1. Postoperative delirium was recorded. Predictors of delirium and length of stay were assessed by univariate logistic regression and the latter with multivariate linear regression. Overall 274 patients were included, of which 47% had a Clock Draw Test score of 0 or 1. Post-operative delirium occurred in 17 (6%). CI was a predictor of postoperative delirium (odds ratio, 3.9; 95% CI, 1.2-12; = .02). Postoperative delirium was a predictor of increased length of stay (adjusted odds ratio, 1.30; 95% CI, 1.07-1.57; = .0073) on multivariate regression while baseline Clock Draw Test result was not a predictor on univariate regression ( = .98). Screening for CI can help predict delirium and facilitate targeted interventions in the postoperative period.
研究目的是测量认知障碍（CI）和谵妄的发生率和预测因素。接受头颈部大手术的成年人完成了时钟测验以筛查 CI，CI 的定义为得分 0 或 1。记录术后谵妄。使用单变量逻辑回归评估谵妄和住院时间的预测因素，后者使用多元线性回归。共纳入 274 例患者，其中 47%的患者时钟测验得分为 0 或 1。术后谵妄发生在 17 例（6%）。CI 是术后谵妄的预测因素（优势比，3.9；95%置信区间，1.2-12；p =.02）。术后谵妄是住院时间延长的预测因素（调整后的优势比，1.30；95%置信区间，1.07-1.57；p =.0073），而基线时钟测验结果在单变量回归中不是预测因素（p =.98）。CI 的筛查有助于预测谵妄，并在术后期间促进有针对性的干预。
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