Division of Big Data and Artificial Intelligence, Institute of New Frontier Research, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24253, Korea.
Department of Anesthesiology and Pain Medicine, College of Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24253, Korea.
Medicina (Kaunas). 2022 Feb 11;58(2):268. doi: 10.3390/medicina58020268.
For preventing postoperative delirium (POD), identifying the risk factors is important. However, the relationship between blood transfusion and POD is still controversial. The aim of this study was to identify the risk factors of POD, to evaluate the impact of blood transfusion in developing POD among people undergoing spinal fusion surgery, and to show the effectiveness of big data analytics using a clinical data warehouse (CDW). The medical data of patients who underwent spinal fusion surgery were obtained from the CDW of the five hospitals of Hallym University Medical Center. Clinical features, laboratory findings, perioperative variables, and medication history were compared between patients without POD and with POD. 234 of 3967 patients (5.9%) developed POD. In multivariate logistic regression analysis, the risk factors of POD were as follows: Parkinson's disease (OR 5.54, 95% CI 2.15-14.27; < 0.001), intensive care unit (OR 3.45 95% CI 2.42-4.91; < 0.001), anti-psychotics drug (OR 3.35 95% CI 1.91-5.89; < 0.001), old age (≥70 years) (OR 3.08, 95% CI 2.14-4.43; < 0.001), depression (OR 2.8 95% CI 1.27-6.2; < 0.001). The intraoperative transfusion (OR 1.1, 95% CI 0.91-1.34; = 0.582), and the postoperative transfusion (OR 0.91, 95% CI 0.74-1.12; = 0.379) had no statistically significant effect on the incidence of POD. There was no relationship between perioperative blood transfusion and the incidence of POD in spinal fusion surgery. Big data analytics using a CDW could be helpful for the comprehensive understanding of the risk factors of POD, and for preventing POD in spinal fusion surgery.
为了预防术后谵妄（POD），识别风险因素很重要。然而，输血与 POD 之间的关系仍存在争议。本研究旨在确定 POD 的风险因素，评估在接受脊柱融合手术的人群中输血对 POD 发展的影响，并展示使用临床数据仓库（CDW）进行大数据分析的效果。从翰林大学医疗中心的五家医院的 CDW 中获得了接受脊柱融合手术的患者的医疗数据。比较了无 POD 患者和有 POD 患者的临床特征、实验室检查结果、围手术期变量和用药史。3967 例患者中有 234 例（5.9%）发生了 POD。在多变量逻辑回归分析中，POD 的危险因素如下：帕金森病（OR 5.54，95%CI 2.15-14.27；<0.001）、重症监护病房（OR 3.45 95%CI 2.42-4.91；<0.001）、抗精神病药物（OR 3.35 95%CI 1.91-5.89；<0.001）、年龄较大（≥70 岁）（OR 3.08，95%CI 2.14-4.43；<0.001）、抑郁（OR 2.8 95%CI 1.27-6.2；<0.001）。术中输血（OR 1.1，95%CI 0.91-1.34；=0.582）和术后输血（OR 0.91，95%CI 0.74-1.12；=0.379）对 POD 的发生率无统计学意义。脊柱融合手术中围手术期输血与 POD 的发生率之间没有关系。使用 CDW 的大数据分析可以帮助全面了解 POD 的风险因素，并预防脊柱融合手术中的 POD。
