Wang Zhen-Hua, Jiang Yu, Fang Tao, Li Jin-Qiu, Wang Tai, Zhou Chun-Yang, Wang Rong, Cai Wen-Tao, Liu Hai
Department of Anesthesiology, Kailuan General Hospital, Tangshan, China.
Operating Room, Kailuan General Hospital, Tangshan, China.
Front Med (Lausanne). 2025 Jul 9;12:1577424. doi: 10.3389/fmed.2025.1577424. eCollection 2025.
Identifying modifiable risk factors for postoperative delirium (POD) is essential for prevention and management. The Ideal Cardiovascular Health Score (CHS), a composite measure of cardiovascular health, has been shown to reduce the risk of various chronic diseases. However, its association with POD has not been extensively explored. This study aims to examine the relationship between CHS and the risk of POD in a cohort of surgical patients.
Data from the Kailuan Study, a large longitudinal cohort, were used for this analysis. A total of 1,082 participants aged 18-98 years, who underwent non-cardiac surgery under general anesthesia from 2016 to 2021, were included. The CHS was calculated based on seven cardiovascular health metrics: smoking status, body mass index (BMI), physical activity, diet, blood pressure, fasting blood glucose (FBG), and total cholesterol (TC). POD was diagnosed using the Confusion Assessment Method (CAM). Multivariable logistic regression was employed to assess the association between CHS scores and POD, adjusting for potential confounders.
Among the 1,082 participants, 120 developed POD. Higher CHS scores were inversely associated with the risk of POD. Participants with a CHS ≥ 10 had 55% lower odds of developing POD compared to those with a CHS ≤ 7 (OR = 0.45; 95% CI: 0.23-0.89). This protective effect was observed across various subgroups, including age, sex, and alcohol consumption status. Specific CHS components, such as normal blood pressure (OR = 0.49; 95% CI: 0.31-0.78) and FBG < 5.6 mmol/L (OR = 0.65; 95% CI: 0.47-0.94), were independently associated with reduced POD risk.
A higher CHS score is associated with a lower risk of POD, highlighting the potential protective role of cardiovascular health in preventing postoperative complications.
识别术后谵妄（POD）的可改变风险因素对于预防和管理至关重要。理想心血管健康评分（CHS）作为心血管健康的综合指标，已被证明可降低多种慢性疾病的风险。然而，其与POD的关联尚未得到广泛探讨。本研究旨在调查一组外科手术患者中CHS与POD风险之间的关系。
本分析使用了来自大型纵向队列开滦研究的数据。纳入了2016年至2021年期间在全身麻醉下接受非心脏手术的1082名年龄在18 - 98岁的参与者。CHS基于七个心血管健康指标计算得出：吸烟状况、体重指数（BMI）、身体活动、饮食、血压、空腹血糖（FBG）和总胆固醇（TC）。使用谵妄评估方法（CAM）诊断POD。采用多变量逻辑回归评估CHS评分与POD之间的关联，并对潜在混杂因素进行校正。
在1082名参与者中，有120人发生了POD。较高的CHS评分与POD风险呈负相关。CHS≥10的参与者发生POD的几率比CHS≤7的参与者低55%（OR = 0.45；95%CI：0.23 - 0.89）。在包括年龄、性别和饮酒状况在内的各个亚组中均观察到这种保护作用。特定的CHS组成部分，如血压正常（OR = 0.49；95%CI：0.31 - 0.78）和FBG < 5.6 mmol/L（OR = 0.65；95%CI：0.47 - 0.94），与降低POD风险独立相关。
较高的CHS评分与较低的POD风险相关，突出了心血管健康在预防术后并发症中的潜在保护作用。
