Lu Wenbin, Chang Xinning, Bo Lulong, Qiu Yiqing, Zhang Mingyang, Wang Jiali, Wu Xi, Yu Xiya
Faculty of Anesthesiology, Changhai Hospital, Naval Military Medical University, Shanghai 200433, China.
Department of Neurosurgery, Changhai Hospital, Naval Military Medical University, Shanghai 200433, China.
Brain Sci. 2022 Dec 22;13(1):25. doi: 10.3390/brainsci13010025.
Postoperative delirium (POD) is associated with perioperative complications and mortality. Data on the risk factors for delirium after subthalamic nucleus deep brain stimulation (STN-DBS) surgery is not clarified in Parkinson's disease (PD) patients receiving total intravenous anesthesia. We aimed to investigate the risk factors for delirium after STN-DBS surgery in PD patients.
The retrospective cohort study was conducted, including 131 PD patients who underwent STN-DBS for the first time under total intravenous anesthesia from January to December 2021. Delirium assessments were performed twice daily for 7 days after surgery or until hospital discharge using the confusion assessment method for the intensive care unit. Multivariate logistic regression analysis was used to determine the risk factor of POD.
In total, 22 (16.8%) of 131 patients were in the POD group, while the other 109 patients were in the Non-POD group. Multivariate logistic regression analysis showed that preoperative Mini-mental State Examination score [odds ratio = 0.855, 95% confidence interval = 0.768-0.951, = 0.004] and unified Parkinson's disease rating scale part 3 (on state) score (odds ratio = 1.061, 95% confidence interval = 1.02-1.104, = 0.003) were independently associated with delirium after surgery.
In this retrospective cohort study of PD patients, a lower Mini-mental State Examination score and a higher unified Parkinson's disease rating scale part 3 (on state) score were the independent risk factors for delirium after STN-DBS surgery in PD patients under total intravenous anesthesia.
术后谵妄（POD）与围手术期并发症及死亡率相关。在接受全静脉麻醉的帕金森病（PD）患者中，关于丘脑底核深部脑刺激（STN-DBS）手术后谵妄的危险因素的数据尚不明确。我们旨在研究PD患者STN-DBS手术后谵妄的危险因素。
进行回顾性队列研究，纳入2021年1月至12月首次在全静脉麻醉下接受STN-DBS的131例PD患者。术后7天内或直至出院，每天使用重症监护病房意识模糊评估法进行两次谵妄评估。采用多因素logistic回归分析确定POD的危险因素。
131例患者中，共有22例（16.8%）属于POD组，其余109例患者属于非POD组。多因素logistic回归分析显示，术前简易精神状态检查表评分[比值比=0.855，95%置信区间=0.768-0.951，P=0.004]和帕金森病统一评定量表第3部分（状态）评分（比值比=1.061，95%置信区间=1.02-1.104，P=0.003）与术后谵妄独立相关。
在这项针对PD患者的回顾性队列研究中，较低的简易精神状态检查表评分和较高的帕金森病统一评定量表第3部分（状态）评分是全静脉麻醉下PD患者STN-DBS手术后谵妄的独立危险因素。
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