Health Science Center, Ningbo University, Ningbo, Zhejiang, China.
Department of Anesthesiology, Ningbo No. 6 Hospital, Ningbo, Zhejiang, China.
Medicine (Baltimore). 2023 Aug 25;102(34):e34785. doi: 10.1097/MD.0000000000034785.
Postoperative delirium (POD) refers to acute brain dysfunction occurring within 7 days after operation or before discharge. Frailty refers to the state that the body's physiological reserve is insufficient, so that the compensative capacity to endogenous and exogenous stress stimuli decreases. The purpose of this study is to explore the association of preoperative frailty (PF) with POD in elderly patients undergoing hip arthroplasty.
Totally 228 elderly patients (age ≥ 65 years) who received elective hip arthroplasty in the Ningbo No. 6 Hospital between December 2021 and June 2022 were enrolled. One day before surgery, the frailty phenotype scale was adopted for evaluation of patients' frailty. On the 1st-3rd day after operation, the confusion assessment method was adopted for evaluation of delirium, and the patients were grouped into a POD group and non-POD group. Logistic regression was conducted to analyze the correlation between PF and POD.
Among the patients, the incidence of PF was 30.70% (70/228), and the incidence of delirium within 3 days after operation was 25.88% (59/228). According to binary logistic regression analysis, PF, age, hypertension, diabetes mellitus, and preoperative sleep disorder were independent risk factors for POD in elderly patients undergoing hip arthroplasty (all P < .05).
PF is a crucial risk factor for POD in elderly patients undergoing hip arthroplasty.
术后谵妄（POD）是指术后 7 天内或出院前发生的急性脑功能障碍。衰弱是指机体生理储备不足，导致对内源性和外源性应激刺激的代偿能力降低的状态。本研究旨在探讨老年髋部骨折患者术前衰弱（PF）与 POD 的关系。
选取 2021 年 12 月至 2022 年 6 月在宁波市第六医院择期行髋部骨折手术的 228 例老年患者（年龄≥65 岁）。术前 1 天采用衰弱表型量表评估患者的衰弱情况。术后第 1-3 天采用意识模糊评估法评估谵妄，将患者分为 POD 组和非 POD 组。采用 Logistic 回归分析 PF 与 POD 的相关性。
患者中 PF 的发生率为 30.70%（70/228），术后 3 天内发生谵妄的发生率为 25.88%（59/228）。二元 Logistic 回归分析显示，PF、年龄、高血压、糖尿病、术前睡眠障碍是老年髋部骨折患者发生 POD 的独立危险因素（均 P<0.05）。
PF 是老年髋部骨折患者 POD 的重要危险因素。
