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苏丹外科病房术后谵妄的预测因素:一项多中心、横断面、前瞻性研究。

The predictors of postoperative delirium at surgical units in Sudan: A multicenter, cross-sectional, prospective study.

作者信息

Elnour Asim Ahmed, Babkir Sara, A Al-Kubaissi Khalid

机构信息

PhD, MSc. Program of Clinical Pharmacy, College of Pharmacy, Al Ain University, Abu Dhabi campus, Abu Dhabi-United Arab Emirates. AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates.

MSc, B-Pharm. Clinical Pharmacist, Clinical and Drug Supply Chain Management, MSc in Medical Health Professions Education - Alneelain University and MSc in Hospital Pharmacy - National University, Doctors Without Borders "Medicines Sans Frontiers-MSF": Supply Department Khartoum-Sudan, Sudan.

出版信息

Pharm Pract (Granada). 2022 Jul-Sep;20(3):2705. doi: 10.18549/PharmPract.2022.3.2705. Epub 2022 Sep 1.

Abstract

BACKGROUND

Knowledge of potential and amenable risk factors involved in the development of postoperative delirium (POD) is imperative for successful prevention and subsequent management.

OBJECTIVE

The current study objective was to delineate the risk factors associated with the occurrence of POD among patients undergoing surgical procedures.

METHODS

This multi-center (6 hospitals), cross-sectional prospective hospital-based study recruited 415 subjects aged ≥50 years who were scheduled to undergo different types of surgery. Delirium Observational Screening Scale used for the diagnosis of POD. Short Nutritional Assessment Questionnaire used for assessing the nutritional and the hydration status of patients. Pre and postoperative risk factors analyzed by univariate (chi square) and then multivariate analyses and the incidence rate of POD, was reported.

RESULTS

The main outcome measure was the development of POD. Out of the 385, only 43 subjects (11.2%) developed POD. High American Society of Anesthesiologists score (OR: 10.76, 95% CI: 1.379-83.99, P =0.023), duration of surgery (OR: 5.426, 95% CI: [2.249-13.092]; P =0.0001), were the strongest independent risk factors for the development of POD. Katz Index of Independence in Activities of Daily Living score (OR: 3.227, 95% CI: [1.177-8.844], P =0.023), and age ≥ 70 years (OR: 1.174, 95% CI: [1.015-1.359]; P =0.027) were additional strongest independent risk factors for the development of POD.

CONCLUSION

Based on analysis or study, we found High American Society of Anesthesiologist sore, Katz-ADL, duration of surgery, and advanced age were predictors of POD. Our findings suggest preventive measures initiated in subjects identified at risk of developing POD. These results support the healthcare providers in the early prevention, diagnosis, and timely management of POD.

摘要

背景

了解术后谵妄(POD)发生过程中潜在的及可干预的风险因素对于成功预防及后续管理至关重要。

目的

本研究的目的是明确接受外科手术患者中与POD发生相关的风险因素。

方法

这项多中心(6家医院)、基于医院的横断面前瞻性研究招募了415名年龄≥50岁、计划接受不同类型手术的受试者。使用谵妄观察筛查量表诊断POD。使用简易营养评估问卷评估患者的营养及水合状态。通过单因素(卡方检验)及多因素分析对术前和术后风险因素进行分析,并报告POD的发生率。

结果

主要观察指标是POD的发生情况。在385名受试者中,只有43名(11.2%)发生了POD。美国麻醉医师协会评分高(比值比:10.76,95%置信区间:1.379 - 83.99,P = 0.023)、手术时间(比值比:5.426,95%置信区间:[2.249 - 13.092];P = 0.0001)是POD发生的最强独立风险因素。日常生活活动能力Katz指数评分(比值比:3.227,95%置信区间:[1.177 - 8.844],P = 0.023)以及年龄≥70岁(比值比:1.174,95%置信区间:[1.015 - 1.359];P = 0.027)是POD发生的另外两个最强独立风险因素。

结论

基于分析或研究,我们发现美国麻醉医师协会评分高、Katz日常生活活动能力指数、手术时间及高龄是POD的预测因素。我们的研究结果表明应对有发生POD风险的受试者采取预防措施。这些结果有助于医疗保健人员对POD进行早期预防、诊断及及时管理。

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