与术后认知功能和生活质量变化相关的术前老年特征：一项前瞻性观察性分析多中心研究

Preoperative Geriatric Characteristics Associated with Changes in Postoperative Cognitive Function and Quality of Life: A Prospective Observational Analytic Multicenter Study.

作者信息

Isngadi Isngadi, Asmoro Aswoco A, Huda Nurul, Siswagama Taufiq A, Rehatta Nancy M, Chandra Susilo, Sari Djayanti, Lestari Mayang I, Senapathi Tjokorda G A, Nurdin Haizah, Wirabuana Belindo, Pramodana Bintang, Pradhana Adinda P, Anggraeni Novita, Sikumbang Kenanga M, Halimi Radian A, Jasa Zafrullah K, Nasution Akhyar H, Mochamat Mochamat, Purwoko Purwoko

机构信息

Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Brawijaya University-Dr. Saiful Anwar General Hospital, Malang, Indonesia.

Department of Anesthesiology and Reanimation, Faculty of Medicine, Airlangga University-Dr. Soetomo General Hospital, Surabaya, Indonesia.

出版信息

Ann Geriatr Med Res. 2025 Mar;29(1):28-37. doi: 10.4235/agmr.24.0102. Epub 2024 Sep 12.

DOI:10.4235/agmr.24.0102

PMID:39262332

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12010739/

Abstract

BACKGROUND

Changes in cognitive function are associated with increased depression and decreased quality of life (QOL). This study aimed to determine the relationship between the characteristics of geriatric patients and anesthetic management with changes in postoperative cognitive function and QOL of geriatric patients undergoing elective surgery.

METHODS

This prospective observational analytic multicenter study included patients aged ≥60 years who underwent elective surgery in hospitals in Indonesia. We used the whole sampling method and performed follow-up 30 days after surgery. Data were analyzed using bivariate chi-square and multivariate regression tests with a confidence interval of 95% and α=5%.

RESULTS

Among the 933 geriatric patients included in this study 55.0%, females most (59.8%) received general anesthesia. Factors including age (p<0.001, B=-0.374, odds ratio [OR]=0.688), body mass index (BMI) (p<0.05, B=0.129, OR=1.138), and physical status based on American Society of Anesthesiologists (ASA) classification (p<0.001, B=-0.458, OR=0.633) were significantly associated with postoperative cognitive function. BMI (p<0.001, B=-0.218, OR=1.244), absence of comorbidities (p<0.05, B=-0.312, OR=0.732), regional anesthesia (p<0.05, B=0.606, OR=1.883), and changes in cognitive function (p<0.05, B=0.288, OR=1.334) were significantly correlated with changes in postoperative QOL.

CONCLUSION

Age, BMI, and ASA physical status were significantly associated with postoperative cognitive function in geriatric patients, whereas BMI, comorbidities, regional anesthesia, and changes in postoperative cognitive function were associated with QOL. These preoperative factors can predict postoperative cognitive function and QOL and may be useful during preoperative planning.

摘要

背景

认知功能的变化与抑郁症增加和生活质量（QOL）下降相关。本研究旨在确定老年患者的特征和麻醉管理与接受择期手术的老年患者术后认知功能及生活质量变化之间的关系。

方法

这项前瞻性观察性分析多中心研究纳入了印度尼西亚医院中年龄≥60岁且接受择期手术的患者。我们采用整群抽样方法，并在术后30天进行随访。使用双变量卡方检验和多变量回归检验分析数据，置信区间为95%，α = 5%。

结果

在本研究纳入的933例老年患者中，55.0%的患者接受了全身麻醉，其中女性居多（59.8%）。年龄（p<0.001，B = -0.374，比值比[OR]=0.688）、体重指数（BMI）（p<0.05，B = 0.129，OR = 1.138）以及基于美国麻醉医师协会（ASA）分类的身体状况（p<0.001，B = -0.458，OR = 0.633）等因素与术后认知功能显著相关。BMI（p<0.001，B = -0.218，OR = 1.244）、无合并症（p<0.05，B = -0.312，OR = 0.732）、区域麻醉（p<0.05，B = 0.606，OR = 1.883）以及认知功能变化（p<0.05，B = 0.288，OR = 1.334）与术后生活质量变化显著相关。