首页|非心脏手术老年患者口腔衰弱与术后谵妄的相关性

非心脏手术老年患者口腔衰弱与术后谵妄的相关性

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目的 探讨非心脏手术老年患者口腔衰弱与术后谵妄(POD)的相关性.方法 选择2023年2-7月择期行非心脏手术老年患者268例,男115例,女153例,年龄≥65岁,BMI 14~36 kg/m2,ASA Ⅱ或Ⅲ级.术前1d采用口腔衰弱量表(OFI-8)评估患者术前口腔衰弱状态;术后1~3d使用3分钟POD诊断量表(3D-CAM)评估患者POD发生情况,根据术后3 d是否发生POD将患者分为两组:POD组和非POD组.采用多因素Logistic回归模型分析口腔衰弱与POD的关系.结果 有61例(22.7%)患者发生POD.多因素Logistic回归分析结果显示,在校正年龄、ASA分级、血红蛋白、麻醉时间和输液量因素后,术后使用镇痛泵(OR=2.298,95%CI 1.034~5.108,P=0.041)和口腔衰弱(OR=2.295,95%CI 1.193~4.415,P=0.012)与POD的发生明显相关.结论 术前口腔衰弱的老年患者非心脏手术后POD发生率明显增加,术前口腔衰弱与POD的发生存在明显相关性.
Correlation between oral frailty and postoperative delirium in elderly patients undergoing non-cardiac surgery
Objective To investigate the correlation between oral frailty and POD in elderly patients undergoing non-cardiac surgery.Methods A total of 268 elderly patients,115 males and 153 fe-males,aged ≥ 65 years,BMI 14-36 kg/m2,ASA physical status Ⅱ or Ⅲ,undergoing elective non-cardiac surgery from February 2023 to July 2023 were selected.The oral frailty index-8(OFI-8)was used to measure the oral frailty status of patients one day before surgery.The 3-minute delirium diagnostic scale(3D-CAM)was used to evaluate the occurrence of POD 1,2,3 days after surgery.The patients were divid-ed into delirium group(POD group)and non-delirium group(non-POD group)according to whether POD occurred 3 days after surgery.Multivariate logistic regression model was used to analyze the relationship be-tween oral frailty and POD.Results POD occurred in 61 patients(22.7%).Multivariate logistic regression analysis showed that postoperative use of analgesic pump(OR=2.298,95%CI 1.034-5.108,P=0.041)and oral frailty(OR=2.295,95%CI 1.193-4.415,P=0.012)are significantly correla-ted with the occurrence of POD,after adjusting for age,ASA physical status,hemoglobin,anesthesia time and infusion volume.Conclusion The incidence of postoperative POD in elderly patients with preoperative oral weakness is significantly increased undergoing non-cardiac surgery,and preoperative oral weakness is correlated with the occurrence of POD.

Non-cardiac surgeryAgedOral frailtyPostoperative delirium

段华玮、胡小义、柳权芳、纪木火

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210011 南京医科大学第二附属医院麻醉科

非心脏手术 老年 口腔衰弱 术后谵妄

国家自然科学基金国家自然科学基金

8197189282172131

2024

临床麻醉学杂志
中华医学会南京分会

临床麻醉学杂志

CSTPCD北大核心
影响因子:2.225
ISSN:1004-5805
年,卷(期):2024.40(9)