Suppr超能文献

三级护理医院老年患者术后谵妄的发生率及危险因素:一项回顾性病历审查

Incidence and Risk Factors of Developing Post-operative Delirium Among Elderly Patients in a Tertiary Care Hospital: A Retrospective Chart Review.

作者信息

Almashari Yasser, Alshaya Rand A, Alenazi Radin R, Alanazi Aseel M, Alhanan Reem, Al-Shammari Futoon A, Muawad Rayan

机构信息

Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.

Medicine, Dar Al Uloom University, Riyadh, SAU.

出版信息

Cureus. 2024 Jul 23;16(7):e65188. doi: 10.7759/cureus.65188. eCollection 2024 Jul.

Abstract

Introduction Delirium is an acute and fluctuating decline in attention and cognition caused by reversible neural disruption. Post-operative delirium (POD) may happen 10 minutes after anesthesia administration up to discharge. POD has been associated with increased days of mechanical ventilation, increased patients' functional decline, prolonged intensive care unit (ICU) stay, and prolonged hospital length of stay, which can lead to nosocomial complications, further investigations, and increased treatment costs. In this study, we aim to determine the prevalence of POD and identify demographic or surgical variables associated with POD. Materials and methods This retrospective cross-sectional study was conducted at the National Guard Health Affairs Hospital (NGHA), a teaching tertiary care center in Riyadh, Kingdom of Saudi Arabia. The study included all patients older than 65 who developed POD from January 2017 to January 2023 and a control group of the same time window. The data were analyzed using custom Python code. Results The study included 108 patients, 72 of whom were male patients. General anesthesia was most used compared to other anesthesia techniques (79.630%). Patients with hypertension (HTN) and diabetes mellitus (DM) each account for 75 cases. Elective surgeries account for 86.111% of cases. Our analysis showed a significant association between POD and advanced age, male gender, DM, HTN, congestive heart failure (CHF), and chronic kidney disease (CKD).  Conclusion With our study, we hope to aid the process of better understanding POD to help healthcare providers identify high-risk patients, implement preventative measures, and enhance patient safety and satisfaction.

摘要

引言

谵妄是由可逆性神经功能紊乱引起的注意力和认知能力的急性波动性下降。术后谵妄(POD)可能在麻醉给药后10分钟至出院期间发生。POD与机械通气天数增加、患者功能衰退加剧、重症监护病房(ICU)住院时间延长以及住院时间延长有关,这可能导致医院获得性并发症、进一步检查以及治疗成本增加。在本研究中,我们旨在确定POD的患病率,并识别与POD相关的人口统计学或手术变量。

材料与方法

这项回顾性横断面研究在沙特阿拉伯王国利雅得的一家三级教学护理中心国民警卫队卫生事务医院(NGHA)进行。该研究纳入了2017年1月至2023年1月期间发生POD的所有65岁以上患者以及同一时间窗口的对照组。数据使用定制的Python代码进行分析。

结果

该研究纳入了108名患者,其中72名是男性患者。与其他麻醉技术相比,全身麻醉使用最为频繁(79.630%)。患有高血压(HTN)和糖尿病(DM)的患者各有75例。择期手术占病例的86.111%。我们的分析表明,POD与高龄、男性、DM、HTN、充血性心力衰竭(CHF)和慢性肾脏病(CKD)之间存在显著关联。

结论

通过我们的研究,我们希望有助于更好地理解POD的过程,以帮助医疗保健提供者识别高危患者、实施预防措施并提高患者安全性和满意度。

相似文献

4
Incidence and risk factors of postoperative delirium after pancreatic cancer surgery: a retrospective study.
Surg Today. 2023 Jun;53(6):736-742. doi: 10.1007/s00595-022-02614-4. Epub 2022 Nov 5.
6
Risk factors and associated outcomes of postoperative delirium after open abdominal aortic aneurysm repair.
J Vasc Surg. 2024 Apr;79(4):793-800. doi: 10.1016/j.jvs.2023.11.040. Epub 2023 Nov 30.
7
Congestive heart failure as a determinant of postoperative delirium.
Rev Port Cardiol. 2013 Sep;32(9):665-71. doi: 10.1016/j.repc.2012.12.020. Epub 2013 Sep 6.
9
Early Serum Metabolism Profile of Post-operative Delirium in Elderly Patients Following Cardiac Surgery With Cardiopulmonary Bypass.
Front Aging Neurosci. 2022 Jun 10;14:857902. doi: 10.3389/fnagi.2022.857902. eCollection 2022.

引用本文的文献

本文引用的文献

2
Gender Differences and Postoperative Delirium in Adult Patients Undergoing Cardiac Valve Surgery.
Front Cardiovasc Med. 2021 Nov 23;8:751421. doi: 10.3389/fcvm.2021.751421. eCollection 2021.
3
Spinal Anesthesia or General Anesthesia for Hip Surgery in Older Adults.
N Engl J Med. 2021 Nov 25;385(22):2025-2035. doi: 10.1056/NEJMoa2113514. Epub 2021 Oct 9.
8
Recommendations for the Nomenclature of Cognitive Change Associated with Anaesthesia and Surgery-2018.
Anesthesiology. 2018 Nov;129(5):872-879. doi: 10.1097/ALN.0000000000002334.
9
European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium: erratum.
Eur J Anaesthesiol. 2018 Sep;35(9):718-719. doi: 10.1097/EJA.0000000000000872.
10
Postoperative delirium in total knee and hip arthroplasty patients: a study of perioperative modifiable risk factors.
Br J Anaesth. 2018 May;120(5):999-1008. doi: 10.1016/j.bja.2017.12.046. Epub 2018 Mar 9.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验