...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry >Depression Predicts Delirium After Coronary Artery Bypass Graft Surgery Independent of Cognitive Impairment and Cerebrovascular Disease: An Analysis of the Neuropsychiatric Outcomes After Heart Surgery Study
【24h】

Depression Predicts Delirium After Coronary Artery Bypass Graft Surgery Independent of Cognitive Impairment and Cerebrovascular Disease: An Analysis of the Neuropsychiatric Outcomes After Heart Surgery Study

机译：抑郁症在冠状动脉旁路移植手术独立于认知障碍和脑血管病后预测谵妄：心脏手术研究后神经精神结算的分析

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Objective: Although depression is a known risk factor for delirium after coronary artery bypass graft (CABG) surgery, it is unclear whether this risk is independent of delirium risk attributable to cognitive impairment or cerebrovascular disease. This study examines depression, mild cognitive impairment (MCI), and cerebrovascular disease as post-CABG delirium risk factors. Methods: This prospective observational cohort study was performed in a tertiary-care academic hospital. Subjects were without dementia and undergoing CABG surgery. Preoperative cognitive assessment included Clinical Dementia Rating and neuropsychological battery; depression was assessed using Depression Interview and Structured Hamilton. Baseline intracranial stenosis was evaluated by transcranial Doppler of bilateral middle cerebral arteries (MCAs). Study psychiatrists assessed delirium on postoperative days 2-5 using the Confusion Assessment Method. Results: Our analytic sample comprised 131 subjects (average age: 65.8 +/- 9.2 years, 27% women). MCI prevalence was 24%, preoperative depression 10%, lifetime depression 35%, and MCA stenosis (50%) 28%. Sixteen percent developed delirium. Multivariate analysis revealed that age, MCI (odds ratio [OR]: 5.1; 95% confidence interval [CI]: 1.3-20.1), and preoperative depression (OR: 9.9; 95% CI: 1.3-77.9)-but not lifetime depression-predicted delirium. MCA stenosis and severity predicted delirium in univariate but not multivariate analysis. Right MCA stenosis severity predicted delirium severity, but left-sided stenosis severity did not. Conclusion: We established that the risk of delirium attributable to depression extends beyond the potential moderating influence of cognitive impairment and cerebrovascular disease alone. Even mild depression and cognitive impairment before CABG deserve recognition for their effect on post-CABG cognitive health.
机译：目的：虽然抑郁症是冠状动脉旁路移植物（CABG）手术后谵妄的已知风险因素，但目前尚不清楚这种风险是否与可应合认知障碍或脑血管疾病的谵妄风险无关。本研究检测抑郁，轻度认知障碍（MCI）和脑血管疾病，作为CABG后谵妄危险因素。方法：该预期观察队列研究是在第三级学术院进行的。受试者没有痴呆和接受CABG手术。术前认知评估包括临床痴呆额定值和神经心理电池;使用抑郁面试和结构汉密尔顿评估抑郁症。通过双侧中脑动脉（MCA）的经颅多普勒评估基线颅内狭窄。使用混乱评估方法研究精神科医生在术后2-5分析谵妄。结果：我们的分析样品组成131个科目（平均年龄：65.8 +/- 9.2岁，27％女性）。 MCI患病率为24％，术前抑郁症10％，寿命抑郁35％，MCA狭窄（50％）28％。百分之十六开发的谵妄。多变量分析显示，年龄，MCI（差距[或]：5.1; 95％置信区间[CI]：1.3-20.1）和术前抑郁（或：9.9; 95％CI：1.3-77.9） - 不是终身抑郁症 - 预测的谵妄。 MCA狭窄和严重程度预测谵妄在单变量但不相互作用。正确的MCA狭窄严重程度预测谵妄严重程度，但左侧狭窄严重程度没有。结论：我们认为，抑制抑郁症的风险延伸超出了认知障碍和脑血管疾病的潜在调节影响。甚至在CABG之前的轻度抑郁和认知障碍值得认识到它们对后型CABG认知健康的影响。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号