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心血管手术后术前握力与术后谵妄之间的关联:一项回顾性研究

Association between Preoperative Hand Grip Strength and Postoperative Delirium after Cardiovascular Surgery: A Retrospective Study.

作者信息

Kotani Taichi, Ida Mitsuru, Inoue Satoki, Naito Yusuke, Kawaguchi Masahiko

机构信息

Department of Anesthesiology, Nara Medical University, Kashihara 634-8522, Japan.

Department of Anesthesiology, Fukushima Medical University, Fukushima 960-1295, Japan.

出版信息

J Clin Med. 2023 Apr 4;12(7):2705. doi: 10.3390/jcm12072705.

Abstract

The association of frailty with postoperative delirium has not been fully investigated in patients undergoing cardiovascular surgery. Therefore, this study aimed to investigate whether preoperative hand grip strength is associated with postoperative delirium. This retrospective study included patients aged >65 years who had undergone elective cardiovascular surgery using cardiopulmonary bypass at a Japanese university hospital between April 2020 and February 2022. We defined low hand grip strength as hand grip values of <275 and <177 for men and women, respectively. Postoperative delirium was assessed using the confusion assessment method during patients' intensive care unit stay. The odds ratio of low hand grip strength for postoperative delirium was estimated using multiple logistic analysis, which was adjusted for prominent clinical factors. Ninety-five patients with a median age of 74 years were included in the final analysis, and 31.5% of them had low hand grip strength. Postoperative delirium occurred in 37% of patients, and the odds ratio of low preoperative hand grip strength for postoperative delirium was 4.58 (95% confidence interval: 1.57-13.2). Thirty-seven patients experienced postoperative delirium after cardiovascular surgery using cardiopulmonary bypass, and low preoperative hand grip strength was positively associated with its occurrence.

摘要

在接受心血管手术的患者中,虚弱与术后谵妄之间的关联尚未得到充分研究。因此,本研究旨在调查术前握力是否与术后谵妄有关。这项回顾性研究纳入了2020年4月至2022年2月期间在日本一家大学医院接受择期体外循环心血管手术的65岁以上患者。我们将男性和女性的低握力分别定义为握力值<275和<177。在患者入住重症监护病房期间,使用意识模糊评估方法评估术后谵妄。采用多因素逻辑分析估计低握力与术后谵妄的比值比,并对主要临床因素进行校正。最终分析纳入了95例中位年龄为74岁的患者,其中31.5%的患者握力较低。37%的患者发生了术后谵妄,术前低握力与术后谵妄的比值比为4.58(95%置信区间:1.57 - 13.2)。37例患者在接受体外循环心血管手术后发生了术后谵妄,术前低握力与其发生呈正相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdd8/10095472/413960344f7c/jcm-12-02705-g001.jpg

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