习惯性饮茶与老年患者全髋关节/膝关节置换术后谵妄：PNDABLE 研究。
Habitual tea consumption and postoperative delirium after total hip/knee arthroplasty in elderly patients: The PNDABLE study.
机构信息
Department of Anesthesiology, Qingdao Municipal Hospital Affiliated to Qingdao University, Qingdao, China.
Department of Anesthesiology, Qingdao Women and Children's Hospital, Qingdao, China.
出版信息
Brain Behav. 2022 Jun;12(6):e2612. doi: 10.1002/brb3.2612. Epub 2022 May 12.
PURPOSE
To clarify the effects of habitual tea consumption on postoperative delirium (POD) in elderly patients undergoing total hip/knee arthroplasty.
PATIENTS AND METHODS
A prospective cohort study was carried out at Qingdao Municipal Hospital Affiliated to Qingdao University between June 2020 and June 2021. A total of 332 patients aged 65-85 years undergoing total hip/knee arthroplasty under combined spinal and epidural anesthesia were enrolled from the Perioperative Neurocognitive Disorder and Biomarker Lifestyle (PNDABLE) study in the final analysis, consisting of 168 patients with habitual tea consumption and 164 patients with infrequent tea consumption. The primary endpoint was the effects of habitual tea consumption on POD and the incidence of POD, which was assessed by the Confusion Assessment Method (CAM) twice daily during the first 7 postoperative days, and POD severity was measured by the Memorial Delirium Assessment Scale (MDAS). The secondary endpoints were the concentrations of caffeine and tea polyphenols in plasma and cerebrospinal fluid (CSF), which were detected by the enzyme-linked immunosorbent assay.
RESULTS
POD occurred in 61 of 332 patients (18.37%), among whom 19 had habitual tea consumption (5.72%) and 42 had infrequent tea consumption (12.65%). Habitual tea consumption (odds ratio [OR] = 0.370, 95% confidence interval [CI]: 0.205-0.670, P = .001) was significantly associated with POD in the logistic analysis, and then after adjusting for age and American Society of Anesthesiologists (ASA) physical status (OR = 0.353, 95% CI: 0.190-0.655, P = .001). Furthermore, caffeine in T plasma (OR = 0.834, 95% CI: 0.752-0.924, P = .001), T plasma (OR = 0.818, 95% CI: 0.738-0.908, P < .001), and CSF (OR = 0.899, 95% CI: 0.820-0.984, P = .022) and tea polyphenols in T plasma (OR = 0.541, 95% CI: 0.416-0.704, P < .001), T plasma (OR = 0.477, 95% CI: 0.359-0.633, P < .001), and CSF (OR = 0.526, 95% CI: 0.397-0.696, P < .001) were associated with POD after adjusting for age and ASA physical status.
CONCLUSION
Habitual tea consumption may be associated with a lower incidence of POD in elderly patients.
目的
阐明习惯性饮茶对接受全髋关节/膝关节置换术的老年患者术后谵妄（POD）的影响。
方法
本前瞻性队列研究于 2020 年 6 月至 2021 年 6 月在青岛大学附属医院进行，最终纳入来自围手术期神经认知障碍和生物标志物生活方式（PNDABLE）研究的 332 例年龄 65-85 岁接受椎管内麻醉联合全身麻醉下全髋关节/膝关节置换术的患者，其中习惯性饮茶者 168 例，不常饮茶者 164 例。主要终点是习惯性饮茶对 POD 及 POD 发生率的影响，术后第 1 至 7 天每日采用意识错乱评估方法（CAM）评估 2 次，采用记忆谵妄评估量表（MDAS）评估 POD 严重程度。次要终点是通过酶联免疫吸附试验检测血浆和脑脊液（CSF）中咖啡因和茶多酚的浓度。
结果
332 例患者中有 61 例（18.37%）发生 POD，其中习惯性饮茶者 19 例（5.72%），不常饮茶者 42 例（12.65%）。Logistic 分析显示，习惯性饮茶（比值比[OR] = 0.370，95%置信区间[CI]：0.205-0.670，P =.001）与 POD 显著相关，调整年龄和美国麻醉医师协会（ASA）身体状况后（OR = 0.353，95%CI：0.190-0.655，P =.001）。此外，T 血浆中咖啡因（OR = 0.834，95%CI：0.752-0.924，P =.001）、T 血浆（OR = 0.818，95%CI：0.738-0.908，P <.001）和 CSF（OR = 0.899，95%CI：0.820-0.984，P =.022）及 T 血浆中茶多酚（OR = 0.541，95%CI：0.416-0.704，P <.001）、T 血浆（OR = 0.477，95%CI：0.359-0.633，P <.001）和 CSF（OR = 0.526，95%CI：0.397-0.696，P <.001）与 POD 相关，调整年龄和 ASA 身体状况后。
结论
习惯性饮茶可能与老年患者 POD 发生率降低有关。
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