Joo Yong-Bum, Kim Young-Mo, Lee Woo-Yong, Park Young-Cheol, Park Jae-Young, Lee Chang-Sin
Department of Orthopedic Surgery, Chungnam National University Hospital, Chungnam National University College of Medicine, Munhwa-dong, Jung-gu, Daejeon 35015, Republic of Korea.
Department of Orthopedic Surgery, Daejeon Eulji Medical Center, Eulji University School of Medicine, 95, Dunsanseo-ro, Seo-gu, Daejeon 35233, Republic of Korea.
Medicina (Kaunas). 2025 Apr 15;61(4):733. doi: 10.3390/medicina61040733.
: Postoperative delirium (PODil) is a cognitive condition characterized by sudden fluctuations in consciousness and orientation after surgery. PODil following total knee arthroplasty (TKA) is associated with prolonged hospital stays and increased morbidity. Therefore, prevention of PODil is particularly important. Life's Simple 7 score, published by the American Heart Association, is a new measure of cardiovascular health (CVH). Better CVH is associated with a lower risk of cognitive impairment. Hence, this study aimed to determine whether Life's Simple 7 score is associated with PODil following TKA. : This retrospective study included 973 patients who underwent TKA between January 2015 and January 2020. Patients were divided into two groups (group I: delirium group, = 60; group II: non-delirium group, = 913). Demographic data, use of analgesics, surgical factors, underlying diseases, laboratory results, and Life's Simple 7 score were evaluated. : Significant differences were observed between the two groups for Parkinson's disease, intraoperative hypotension, preoperative duloxetine administration, and Life's Simple 7 score. In the receiver operating characteristic (ROC) curve analysis, the optimal cut-off value for Life's Simple 7 score was determined to be 8 at the maximal Youden index, with an area under the curve (AUC) of 0.82, a sensitivity of 0.92, and a specificity of 0.58. : Lower Life's Simple 7 score is an independent risk factor for the incidence of PODil after TKA. Given its ease of measurement, Life's Simple 7 score may be a useful measure for predicting PODil and will aid in preoperative risk assessment and post-operative patient management.
术后谵妄（PODil）是一种认知状态，其特征为术后意识和定向力突然波动。全膝关节置换术（TKA）后的PODil与住院时间延长和发病率增加相关。因此，预防PODil尤为重要。美国心脏协会发布的生命简单7分评分是心血管健康（CVH）的一项新指标。更好的CVH与较低的认知障碍风险相关。因此，本研究旨在确定生命简单7分评分是否与TKA后的PODil相关。
这项回顾性研究纳入了2015年1月至2020年1月期间接受TKA的973例患者。患者分为两组（I组：谵妄组，n = 60；II组：非谵妄组，n = 913）。评估了人口统计学数据、镇痛药使用情况、手术因素、基础疾病、实验室检查结果和生命简单7分评分。
两组在帕金森病、术中低血压、术前使用度洛西汀和生命简单7分评分方面存在显著差异。在受试者工作特征（ROC）曲线分析中，生命简单7分评分的最佳截断值在最大约登指数时确定为8，曲线下面积（AUC）为0.82，灵敏度为0.92，特异度为0.58。
较低的生命简单7分评分是TKA后PODil发生的独立危险因素。鉴于其易于测量，生命简单7分评分可能是预测PODil的有用指标，并将有助于术前风险评估和术后患者管理。
