Medical School of Chinese People's Liberation Army, Beijing, China.
Department of Anesthesiology, The Fourth Medical Center of Chinese, PLA General Hospital, Beijing, China.
BMC Geriatr. 2023 Nov 13;23(1):735. doi: 10.1186/s12877-023-04425-9.
Postoperative delirium (POD) is a common complication in elderly patients after hip fracture surgery. Our study was to investigate whether intraoperative mean arterial pressure variability (MAPV) was associated with POD in elderly patients after hip fracture surgery.
In this retrospective cohort study, patients aged 65 years and older undergoing hip fracture surgery were included. The correlation between MAPV and POD was investigated using univariate and multivariate logistic regression. Covariate-related confounding effects were eliminated with propensity score matching (PSM) analysis. Then, a subgroup analysis was conducted to further examine the associations between MAPV and POD.
Nine hundred sixty-three patients with a median age of 80 years (IQR: 73-84) were enrolled. POD occurred in 115/963 (11.9%) patients within 7 days after surgery. According to multivariate regression analysis, MAPV > 2.17 was associated with an increased risk of POD (OR: 2.379, 95% CI: 1.496-3.771, P < 0.001). All covariates between the two groups were well balanced after PSM adjustment. A significant correlation between MAPV and POD was found in the PSM analysis (OR: 2.851, 95% CI: 1.710-4.746, P < 0.001).
An increased intraoperative MAPV may be a predictor for POD.
术后谵妄（POD）是老年髋部骨折手术后的常见并发症。我们的研究旨在探讨术中平均动脉压变异（MAPV）是否与老年髋部骨折手术后 POD 相关。
在这项回顾性队列研究中，纳入了年龄在 65 岁及以上接受髋部骨折手术的患者。使用单因素和多因素逻辑回归分析 MAPV 与 POD 之间的相关性。通过倾向评分匹配（PSM）分析消除协变量相关的混杂效应。然后进行亚组分析，以进一步研究 MAPV 与 POD 之间的关联。
共纳入 963 例年龄中位数为 80 岁（IQR：73-84）的患者。术后 7 天内有 115/963（11.9%）例患者发生 POD。根据多因素回归分析，MAPV＞2.17 与 POD 风险增加相关（OR：2.379，95%CI：1.496-3.771，P＜0.001）。PSM 调整后两组间所有协变量均得到良好平衡。PSM 分析中发现 MAPV 与 POD 之间存在显著相关性（OR：2.851，95%CI：1.710-4.746，P＜0.001）。
术中 MAPV 增加可能是 POD 的预测指标。
