摘要
目的探讨老年患者髋关节术后早期谵妄的危险因素。方法回顾性分析2017年10月—2018年10月重症监护室髋关节术后的121例老年患者的临床资料。采用CAM-ICU对患者进行评估,根据24h内是否发生谵妄,将患者分为谵妄组与非谵妄组,统计术后24h谵妄的发生率。应用Logistic回归分析筛选出术后谵妄可能的危险因素,再将可能的危险因素纳入二分类Logistic回归分析,进一步筛选出老年患者髋关节术后早期谵妄的独立危险因素。结果121例患者中发生早期术后谵妄49例,发生率为40.5%。谵妄组与非谵妄组患者在年龄、APACHEⅡ评分、手术时间、术中失血量、脑卒中史和肢体约束史方面差异有统计学意义。而在性别、血清肌酐值、肝功能Child-Pugh分级、麻醉方式、手术方式、高血压史、冠心病史、糖尿病史和慢性阻塞性肺疾病史方面差异没有统计学意义。二分类Logistic回归分析结果显示,年龄[OR=1.972,95%CI=(1.012,3.525)]和脑卒中史[OR=3.700,95%CI=(1.409,9.703)]是髋部手术术后早期谵妄发生的独立危险因素(P<0.05)。结论年龄和脑卒中史是老年患者髋关节术后早期谵妄发生的独立危险因素。
Objective To discuss the risk factors of early deliriumfollowing hip joint surgery in the elderly.Methods A retrospective analysis was made to the clinical data of 121 elderly after hip joint surgery in ICU during the period from Oct., 2017 to Oct.,2018;Confusion Assessment Method for ICU (CAM-ICU) was applied in the evaluation of the cases who were divided,based on the occurrence of delirium,into 2 groups: deliriumgroup and non-deliriumgroup,and the occurrence of delirium in 24 hours after surgery was statistically analyzed;were first screened out by logistic regression analysis was first applied to screen out the possible risk factors and then binary logistic regression analysis was applied to the possible risk factors to further screen out the independent risk factors of early delirium following hip joint surgery in the elderly.Results Early delirium after surgery occurred in 49 cases out of the 121 elderly with the rate of 40.5%;there existed statistical differences in age,the APACHE II scores,the operation time length,bleeding volume in operation,history of stroke and history of limb restraint between the 2 groups while no statistical differences in gender,serum creatinine values,Child-Pugh class of liver function,anesthesia modes,operation methods,history of hypertension,coronary heart disease,diabetes and chronic obstructive pulmonary diseases between the 2 groups;binary logistic regression analysis indicated that age [OR=1.972,95% CI=(1.012,3.525)] and history of stroke [OR=3.700,95%CI=(1.409,9.703)] were the independent risk factors of early delirium following hip joint surgery (P<0.05).Conclusions Age and history of stroke are the independent risk factors of early delirium following hip joint surgery in the elderly.
作者
陆小川
宋晓华
俞瑞东
金凯
吴志雄
张智
范永前
韩冰
Lu Xiaochuan;Song Xiaohua;Yu Ruidong;Jin Kai;Wu Zhixiong;Zhang Zhi;Fan Yongqian;Han Bing(Intensive Care Unit,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China;Department of Orthopaedics,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China)
出处
《老年医学与保健》
CAS
2019年第3期335-338,共4页
Geriatrics & Health Care
关键词
老年
髋关节
术后谵妄
危险因素
elderly
hip joint
delirium after surgery
risk factor
