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首页> 外文期刊>BMC Geriatrics >Incidence of and risk factors for postoperative delirium in older adult patients undergoing noncardiac surgery: a prospective study
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Incidence of and risk factors for postoperative delirium in older adult patients undergoing noncardiac surgery: a prospective study

机译：年龄较大的成人患者术后谵妄患者的发病率和危险因素患者术后患者：一项潜在研究

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To identify the incidence of, risk factors for, and outcomes associated with postoperative delirium (POD) in older adult patients who underwent noncardiac surgery. This prospective study recruited patients aged ≥ 60?years who were scheduled to undergo noncardiac surgery at Siriraj Hospital (Bangkok, Thailand). Functional and cognitive statuses were assessed preoperatively using Barthel Index (BI) and the modified Informant Questionnaire on Cognitive Decline in the Elderly, respectively. POD was diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition criteria. Incidence of POD was reported. Univariate and multivariate analyses were used to identify risk factors for POD. Of the 249 included patients, 29 (11.6%) developed POD. Most patients (61.3%) developed delirium on postoperative day 1. Univariate analysis showed age ≥ 75?years, BI score ≤ 70, pre-existing dementia, preoperative use of opioid or benzodiazepine, preoperative infection, and hematocrit ?30% to be significantly associated with POD. Multivariate logistic analysis revealed pre-existing dementia (adjusted risk ratio [RR]: 3.95, 95% confidence interval [CI]: 1.91–8.17; p??0.001) and age ≥ 75?years (adjusted RR: 2.54, 95% CI: 1.11–5.80; p?=?0.027) to be independent risk factors for POD. Median length of hospital stay was 10 (range: 3–36) days for patients with POD versus 6 (range: 2–76) days for those without delirium (p??0.001). POD remains a common surgical complication, with an incidence of 11.6%. Patients with pre-existing dementia and age ≥ 75?years are the most vulnerable high-risk group. A multidisciplinary team consisting of anesthesiologists and geriatricians should implement perioperative care to prevent and manage POD.
机译：鉴定患有非心动外科手术的老年成年患者术后谵妄（POD）的发生率，危险因素和结果。这种前瞻性研究招募了≥60岁的患者患者，该年龄被安排在Siriraj医院（泰国曼谷，泰国）进行非心律手术。使用Barthel指数（BI）和改良的信息问卷分别进行了术前评估了功能和认知状态。基于精神障碍第五版标准的诊断和统计手册诊断豆荚。报道了豆荚的发病率。使用单变量和多变量分析来识别POD的危险因素。其中249名患者，29例（11.6％）开发的豆荚。大多数患者（61.3％）在术后第1天发达的谵妄1.单变量分析显示年龄≥75岁，BI得分≤70，预先存在的痴呆，术前使用阿片或苯二氮卓，术前感染和血细胞比容<30％与豆荚显着相关。多变量物流分析显示出预先存在的痴呆（调整风险比[RR]：3.95,95％置信区间[CI]：1.91-8.17; p？<0.001）和年龄≥75？年（调整为$$：2.54,95％ CI：1.11-5.80; p？= 0.027）是豆荚的独立风险因素。对于没有谵妄的患者而言，医院住宿的中位数为10（范围：3-36）天数（范围：2-76）天（P？<0.001）。豆荚仍然是常见的手术并发症，发病率为11.6％。患有预先存在的痴呆症和年龄≥75岁的患者是最脆弱的高风险群体。由麻醉师和老年人组成的多学科团队应实施围手术期，以防止和管理豆荚。

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