经典高分文献阅读·葡萄牙老年患者术前认知能力、局部脑氧饱和度和术后谵妄的相关性

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Association Among Preoperative Cognitive Performance, Regional Cerebral Oxygen Saturation, and Postoperative Delirium in Older Portuguese Patients

葡萄牙老年患者术前认知能力、局部脑氧饱和度和术后谵妄的相关性
01

背景
BACKGROUND: Postoperative delirium is common among older patients and preoperative identification of high-risk patients is widely recommended. The aim of this study was to assess whether preoperative cognitive performance using brief screening tools or regional cerebral oxygen saturation (Scto2) was associated with the development of postoperative delirium in older Portuguese patients undergoing elective surgery.
02
方法
METHODS: Prospective observational cohort study where preoperative cognitive screening tools (Mini-Cog, Mini-Mental State Examination, verbal fluency) and Scto2 (INVOS 5100C; Medtronic, Ireland) were assessed in 238 patients ≥65 years old undergoing elective surgery between July 2017 and May 2019 at a tertiary academic center in Portugal. The primary outcome was postoperative delirium detected by the 3D-Confusion Assessment Method. Data were analyzed by univariate analysis and multivariable logistic regression.
方法:使用前瞻性队列研究，采用术前认知筛查工具(Mini-Cog,简易智力状态检查,语言流畅性)和监测Scto2工具(INVOS 5100C;Medtronic, Ireland)对2017年7月至2019年5月期间在葡萄牙一所高等学术中心接受择期手术的238名≥65岁患者进行了评估。主要结果是用3D-Confusion Assessment Method检测术后谵妄。数据采用单因素分析和多因素logistic回归分析。
注：前瞻性队列研究：是队列研究的基本形式。研究对象的分组是根据研究对象现时的暴露状况而定的，此时研究的结果还没有出现，需要前瞻性观察一段时间才能得到
Table&Figure
连续变量：该变量是由数字组成。如年龄、随访时间、身高、体重、肿瘤大小、淋巴结转移分数等
分类变量：该变量下是几个分组。如年龄（＞35 or ≤35两个分组）、性别（男女两组）、肿瘤T分期等

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table2 多变量Logistic回归模型研究Mini-Cog测试出的可能的认知障碍与术后谵妄之间的关系
模型中输入的变量:年龄，性别， ASA分级，长期使用苯二氮平类药物，抑郁，正规教育年限，虚弱，手术风险

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table3 多变量Logistic回归模型研究MMSE测试出的可能的认知障碍与术后谵妄之间的关系