Koga Yusuke, Kitazawa Koji, Shinozaki Gen, Yoshii Kengo, Hughes Jun-Wei B, Yamashita Yohei, Kojima Kentaro, Ueno Morio, Kinoshita Shigeru, Sotozono Chie
Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto, 602-0841, Japan.
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, 94305, USA.
Jpn J Ophthalmol. 2025 Apr 30. doi: 10.1007/s10384-025-01200-8.
To investigate the incidence rate and risk factors for postoperative delirium (POD) following ophthalmic surgery under local anesthesia.
A retrospective study METHODS: We retrospectively investigated the incidence rate of POD in 4658 patients who underwent vitrectomy or glaucoma surgery between January 2009 to March 2023 and analyzed the risk factors with multivariate logistic regression compared to non-delirium patients. Risk indices included age, sex, operation time, preoperative best-corrected visual acuity (pre-BCVA), comorbidity of dementia, and the use of sedative or hypnotic drugs.
POD developed in 19 out of 4658 patients (0.41%). POD was more prevalent in older patients and those with dementia (P < 0.001 and P < 0.001, respectively). However, sex, longer operation time, the use of sedative or hypnotic drugs were not associated with POD. The low pre-BCVA in either operated eye or fellow eye was more likely observed in patients with POD (P = 0.003 and P = 0.001, respectively). The multivariate logistic regression analysis revealed that age (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.00-1.12; P = 0.04), dementia (OR, 34.95; 95% CI, 12.32-99.15; P < 0.001), pre-BCVA in the operated eye (OR, 2.00; 95% CI, 1.13-3.53; P = 0.02) and pre-BCVA in the fellow eye (OR, 1.83; 95% CI, 1.16-2.89; P = 0.01) were significantly associated with developing POD.
POD developed following ophthalmic surgery under local anesthesia. Identified risk factors included older age, comorbid dementia and low pre-BCVA.
探讨局部麻醉下眼科手术后谵妄（POD）的发生率及危险因素。
一项回顾性研究
我们回顾性调查了2009年1月至2023年3月期间接受玻璃体切除术或青光眼手术的4658例患者中POD的发生率，并与非谵妄患者进行比较，采用多因素逻辑回归分析危险因素。风险指标包括年龄、性别、手术时间、术前最佳矫正视力（pre-BCVA）、痴呆症合并症以及镇静或催眠药物的使用情况。
4658例患者中有19例发生POD（0.41%）。POD在老年患者和痴呆患者中更为常见（分别为P < 0.001和P < 0.001）。然而，性别、手术时间延长、镇静或催眠药物的使用与POD无关。POD患者更有可能出现患眼或对侧眼的pre-BCVA较低（分别为P = 0.003和P = 0.001）。多因素逻辑回归分析显示，年龄（比值比[OR]，1.06；95%置信区间[CI]，1.00 - 1.12；P = 0.04）、痴呆症（OR，34.95；95% CI，12.32 - 99.15；P < 0.001）、患眼的pre-BCVA（OR，2.00；95% CI，1.13 - 3.53；P = 0.02）和对侧眼的pre-BCVA（OR，1.83；95% CI，1.16 - 2.89；P = 0.01）与发生POD显著相关。
局部麻醉下眼科手术后会发生POD。已确定的危险因素包括年龄较大、合并痴呆症和pre-BCVA较低。
