Objective To investigate the incidence of preoperative cognitive impairment in elderly patients undergoing hepa-tobiliary surgery and the relationship between preoperative cognitive impairment and postoperative delirium.Methods A total of 216 elderly patients who underwent laparoscopic hepatobiliary surgery were selected and divided into the normal group(167 ca-ses)and the preoperative cognitive impairment group(49 cases)according to the score of the MMSE scale.The Chinese version of the 3D-CAM was used to assess the occurrence of POD in the first 3 days after surgery.The general data and the occurrence of POD were compared between the two groups.The risk factors of POD in elderly patients with hepatobiliary surgery were studied by logistic regression,and the predictive efficacy of MMSE score on POD was studied by ROC curve.Results There were statis-tically significant differences in age,years of education,cerebrovascular diseases,serum albumin and POD between the two groups(P＜0.05 or P＜0.001).Logistic regression showed that preoperative cognitive impairment,increasing age and decrea-sing serum albumin were independent risk factors for POD in elderly patients undergoing hepatobiliary surgery(P＜0.05).The area under ROC curve of preoperative MMSE prediction of POD in elderly patients with hepatobiliary surgery was 0.774.When the preoperative critical MMSE score was 21,the sensitivity and specificity were 71.8％and 81.0％,respectively.Conclusion The incidence of preoperative cognitive impairment was 22.7％in elderly patients with hepatobiliary surgery.Preoperative cog-nitive impairment is closely related to postoperative delirium in elderly patients,and is one of the independent risk factors for postoperative delirium in elderly patients,and can be used as a predictor of preoperative risk stratification.
万方数据
维普
