Objective To investigate the predictive value of Duke anesthesia resistance scale(DARS)for postoperative delirium in elder-ly patients undergoing total hip arthroplasty(THA).Methods A retrospective study was conducted.The elderly patients who underwent elective THA surgery in Hefei Third People's Hospital from January 2020 to April 2023 were selected as the research subjects.The delirium diagnostic scale(CAM)was used to evaluate the postoperative 3 d postoperative delirium.The patients were divided into the postoperative delirium group(n=27)and the non-postoperative delirium group(n=149).Through the electronic medical record system to obtain general information of patients,including preoperative data and intraoperative data,preoperative data included age,gender,body mass index,number of complications,type of surgery,American society of anesthesiologists(ASA)classification,and preoperative mini-mental state examination(MMSE)score;in-traoperative data included operation time,anesthesia time,intraoperative medication and blood loss.The DARS score was calculated by minimum effective end-expiratory alveolar concentration(MACbar),mean end-expiratory concentration((-E)TAC)and bispectral index(BIS).The post-operative hospital stay,new cardiovascular and cerebrovascular events and postoperative infection events at 28 days after operation were counted.Results There was no statistically significant difference in gender composition ratio,operation type,ASA classification and preoperative MMSE score between the two groups(P＞0.05).The age and number of complications in the postoperative delirium group were(76.74±7.23)years old and(2.22±0.42)kinds,respectively,which were higher than those in the non-postoperative delirium group[(65.56±6.04)years old and(1.73±0.44)kinds],and the differences were statistically significant(P＜0.05).There were no statistically significant differences in op-eration time,anesthesia time and bleeding volume between the postoperative delirium group and the non-postoperative delirium group(P＞0.05).The DARS score of the postoperative delirium group was(23.30±4.51)points,which was lower than that of the non-postoperative delirium group[(36.65±8.07)points],and the difference was statistically significant(P＜0.05).ROC analysis showed that the area under the curve of DARS for predicting POD after THA in the elderly was 0.924,95％CI was 0.882-0.967,and the optimal cutoff value was 30 points.At this time,the sensitivity was 0.895 and the specificity was 0.864.There was no statistically significant difference in the incidence of new cardiovascu-lar and cerebrovascular events and infection events between the two groups within 28 days after operation(P＞0.05).The hospitalization time of patients with DARS＜30 points was(10.53±2.71)d,which was higher than that of patients with DARS≥30 points[(7.96±2.30)d],and the difference was statistically significant(P＜0.05).Conclusion DARS can accurately predict POD after THA,and has a certain impact on the short-term prognosis of patients,which is suitable for clinical application.
关键词
杜克麻醉抵抗量表/髋关节置换术/老年/谵妄/短期预后
Key words
Duke anesthesia resistance scale/Hip replacement/Old age/Delirium/Short-term prognosis
维普
万方数据