Postoperative delirium and cognitive dysfunction.
Postoperative delirium and cognitive dysfunction.
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DOI：
10.1093/bja/aep291
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发表时间：
2009-12-01
影响因子：
9.8
通讯作者：
Silverstein, J H
中科院分区：
文献类型：
--
作者：
Deiner, S;Silverstein, J H
术后谵妄和认知功能障碍（POCD）是老年外科人群中特别重要的主题。它们是独立的实体，其关系尚未完全阐明。虽然不限于老年患者，但两者的发生率和影响在老年患者中更为深远。谵妄已被证明与更长和更昂贵的住院过程和更高的可能性死亡6个月内或术后机构。POCD与死亡率增加，过早离开劳动力市场的风险以及对社会转移支付的依赖有关。在这里，我们回顾了它们的定义和病因，并讨论了老年患者接受重大非心脏手术的治疗和预防。良好的基本护理要求识别高危患者，了解常见的围手术期加重因素，简单的预防干预措施，识别疾病状态，并对有严重多动症表现的患者进行基本治疗。
Postoperative delirium and cognitive dysfunction (POCD) are topics of special importance in the geriatric surgical population. They are separate entities, whose relationship has yet to be fully elucidated. Although not limited to geriatric patients, the incidence and impact of both are more profound in geriatric patients. Delirium has been shown to be associated with longer and more costly hospital course and higher likelihood of death within 6 months or postoperative institutionalization. POCD has been associated with increased mortality, risk of leaving the labour market prematurely, and dependency on social transfer payments. Here, we review their definitions and aetiology, and discuss treatment and prevention in elderly patients undergoing major non-cardiac surgery. Good basic care demands identification of at-risk patients, awareness of common perioperative aggravating factors, simple prevention interventions, recognition of the disease states, and basic treatments for patients with severe hyperactive manifestations.