老年髋关节置换术患者全身麻醉术后认知功能障碍的列线图预测模型构建与评估
Construction and evaluation of a nomogram prediction model for postoperative cognitive dysfunction in elderly patients undergoing gen-eral anesthesia hip replacement
李静 1莫强 1唐建富1
作者信息
- 1. 泸州市妇幼保健院(泸州市第二人民医院)麻醉科 四川 泸州 646000
- 折叠
摘要
目的 分析老年髋关节置换术患者全身麻醉术后认知功能障碍(POCD)的影响因素,构建预测老年髋关节置换术患者后POCD的列线图预测模型,并评估模型的区分度和一致性.方法 回顾性选取2018年3月至2021年3月泸州市妇幼保健院(泸州市第二人民医院)收治的60岁以上老年髋关节置换术患者210例为研究对象,用简易智力状态量表(MMSE)对患者神经功能进行评定,将患者分为POCD组40例,非POCD组170例.采用Logistic回归分析影响老年髋关节置换术患者全身麻醉术后POCD的危险因素.采用R软件构建预测老年髋关节置换术患者全身麻醉术后POCD的列线图模型.结果 POCD组患者年龄为75～85岁的比率、糖尿病比率、术后1 d Tau蛋白水平、术后1 d β-淀粉样蛋白水平均明显高于非POCD组,差异均有统计学意义(P＜0.05).Logistic回归分析结果显示,年龄(OR=3.702,95％CI:1.488～9.212)、糖尿病(OR=3.172,95％CI:1.308～7.695)、Tau 蛋白水平(OR=1.051,95％CI:1.018～1.085)、β-淀粉样蛋白水平(OR=1.010,95％CI:1.006～1.015)是影响老年髋关节置换术患者全身麻醉术后POCD的危险因素(P＜0.05).结论 年龄、糖尿病、术后1 d Tau蛋白水平、术后1 dβ-淀粉样蛋白水平是老年髋关节置换术患者全身麻醉术后POCD的影响因素,据此构建的老年髋关节置换术患者全身麻醉术后POCD列线图预测模型,具有较好的区分度和一致性.
Abstract
Objective To analyze the influencing factors of cognitive dysfunction(POCD)after general anesthesia in elderly hip replace-ment patients,construct a nomogram prediction model for predicting postoperative POCD in elderly hip replacement patients,and evaluate the dif-ferentiation and consistency of the model.Methods Retrospectively,210 patients over 60 years old admitted to Luzhou Maternal and Child Health Hospital(Luzhou Second People's Hospital)from March 2018 to March 2021 were selected as study objects to evaluate the neurological function of the mini-mental state examinatlon(MMSE),and then the patients were divided into 40 patients in the POCD group and 170 patients in the non-POCD group.The influencing factors of POCD after general anesthesia in elderly patients undergoing hip replacement were analyzed by Logistic regression analysis.The nomogram model for predicting POCD after general anesthesia in elderly patients undergoing hip replacement was constructed using R software.Results The ratio of 75,85 years,diabetes mellitus,1 d Tau protein,and 1 d(3-amyloid levels were significantly higher than the non-POCD group,and the difference was statistically significant(P＜0.05).Logistic regression analysis showed that age(OR=3.702,95％CI:1.488-9.212),diabetes(OR=3.172,95％CI:1.308-7.695),Tau protein(OR=1.051,95％CI:1.018-1.085)and β-amyloid(OR=1.010,95％CI:1.006-1.015)were risk factors affecting POCD after general anesthesia in elderly hip re-placement patients(P＜0.05).Conclusion Age,diabetes mellitus,1 d Tau protein level and 1 d β-amyloid level are the influencing factors of POCD after general anesthesia in elderly hip replacement patients.Accordingly,the POCD nomogram prediction model after general anesthesia in elderly hip replacement patients has good differentiation and consistency.
关键词
老年髋关节置换术/全身麻醉/术后认知功能障碍/列线图预测模型Key words
Elderly hip replacementt/General anesthesia/Postoperative cognitive dysfunction/Nomogram prediction model引用本文复制引用
基金项目
四川省科学技术厅资助项目(2015SZ0086)
四川省科学技术厅资助项目(LZ-LY-37)
出版年
2024
NETL
NSTL
万方数据