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外文期刊>Clinical Interventions in Aging
>Postoperative Delirium is a Risk Factor of Poor Evolution Three Years After Cardiac Surgery: An Observational Cohort Study
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Postoperative Delirium is a Risk Factor of Poor Evolution Three Years After Cardiac Surgery: An Observational Cohort Study
Background:After cardiac surgery, postoperative delirium (POD) is common and is associated with long-term changes in cognitive function. Impact on health-related quality of life (QOL) and long-term dependence are not well known. This aim of this study is to evaluate the role of POD in poor evolution at three years after surgery including poor QOL and dependence and mortality.Patients and Methods:We enrolled and followed 173 patients 60 years of age or older who were planning to undergo cardiac surgery with cardiopulmonary bypass. The primary composite outcome was death of any causes, or patients with either a loss of QOL (evaluated with of EuroQuol verbal 5D EQ5D less than 50), or a loss of two points on the instrumental activities of daily living occurring three years after surgery. POD was diagnosed with the use of Confusion Assessment Method. Multivariate logistic regression was performed.Results:At three years, 74 patients (42.8%) had a poor evolution. Independent risk factors in poor patient evolution were sex (female gender; OR: 3.6; 95%CI: 1.45-8.7; p=0.006), metabolic status (diabetic patients; OR: 4; 95%CI: 1.6-10.2; p=0.002), Euroscore 2 (Euroscore 2 1.5; OR: 5.2; 95%CI: 1.7-15.4; p=0.003) and POD (OR: 3.3; 95%CI 1.4-7.8; p=0.006). Coronary disease was protective (OR: 0.3; 95%CI: 0.14-0.71; p=0.006).Conclusion:After cardiac surgery, POD significantly altered patient evolution and increased risk of dependence and loss of QOL.? 2020 Labaste et al.
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机译：背景：心脏手术后，术后谵妄（POD）是常见的，与认知功能的长期变化有关。影响与健康有关的生活质量（QOL）和长期依赖性都不是众所周知的。本研究的这种目的是在手术后三年评估Pod在进化中的差的作用，包括差的QoL和依赖和死亡率.Patient和方法：我们注册并随访了173名患者60岁或以上计划进行心脏病的人手术与心肺旁路。主要复合结果是任何原因的死亡，或患者损失的患者（评估为欧元级口头5D EQ5D少于50d），或者在手术后三年内发生的日常生活活动的乐器活动中失去了两点。使用混乱评估方法诊断豆荚。多变量逻辑回归进行。结果：在三年内，74名患者（42.8％）的进化差。患者进化中的独立风险因素是性（女性性别;或：3.6; 95％CI：1.45-8.7; p = 0.006），代谢状态（糖尿病患者;或：4; 95％CI：1.6-10.2; P = 0.002），EuRoscore 2（EuRoscore 2> 1.5;或者：5.2; 95％Ci：1.7-15.4; p = 0.003）和豆荚（或：3.3; 95％CI 1.4-7-7-7.8; P = 0.006）。冠状动脉疾病是保护剂（或：0.3; 95％CI：0.14-0.71; P = 0.006）。结论：在心脏手术后，POD显着改变了患者的演变，增加了依赖性和损失的风险。 2020 Labaste等人。
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