Are preoperative depressive symptoms associated with postoperative delirium in geriatric surgical patients?
Are preoperative depressive symptoms associated with postoperative delirium in geriatric surgical patients?
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DOI：
10.1093/gerona/60.12.1563
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发表时间：
2005-12-01
影响因子：
5.1
通讯作者：
Vaurio, L
中科院分区：
文献类型：
--
作者：
Leung, JM;Sands, LP;Vaurio, L
背景。谵妄在老年手术患者中很常见，预示着负面的健康结果。抑郁症状是否普遍存在并可预测老年手术患者术后谵妄的发生尚未得到研究。我们的研究旨在检查老年手术患者术前抑郁症状的患病率和预后重要性。方法。招募了至少 65 岁、计划进行重大非心脏手术的患者。术前，使用 15 点老年抑郁量表 (GDS) 筛查患者的抑郁症状。使用混乱评估方法测量术后谵妄。协变量与术前抑郁症之间的关联。和术后谵妄通过多变量逻辑回归确定。结果。在所研究的 219 名患者中，平均年龄为 73.6 +/- 16 岁，12% 的患者报告有 6 种或更多抑郁症状。 32% 的人报告了三到五种抑郁症状。通过多变量逻辑回归，与六种或更多抑郁症状相关的患者特征包括受教育年限<12年、功能状态中度至重度受限以及每天饮用两杯以上酒精饮料。术后，46%的患者出现谵妄。术前抑郁症状较多的患者更有可能出现术后谵妄 (p = .048)，并且术后谵妄持续时间较长 (p = .027)。即使在调整后，对于与抑郁和术后谵妄相关的协变量，包括年龄、教育水平、功能状态和术前饮酒，术前抑郁症状超过 6 种的患者术后谵妄持续时间仍明显高于抑郁症状少于 2 种的患者（比值比 = 2.69，置信区间 = 1.04-6.93).结论。老年患者可以轻松地进行术前筛查是否存在抑郁症状。并产生与术后谵妄相关的有用预后信息。
Background. Delirium is common in older surgical patients and predicts negative health Outcomes. Whether depressive symptoms are prevalent and predict the development of postoperative delirium in elderly surgical patients has not been investigated. Our study aimed to examine the prevalence and prognostic importance of preoperative depressive symptoms in older surgical patients.Methods. Patients at least 65 years of age who were scheduled for major noncardiac surgery were recruited. Preoperatively, patients were screened for symptoms of depression using the 15-point Geriatric Depression Scale (GDS). Postoperative delirium was measured using the Confusion Assessment Method. The associations between covariates and preoperative depression. and postoperative delirium were determined by multivariate logistic regression.Results. In the 219 patients studied, the mean age was 73.6 +/- 16 years, 12% of patients reported six or more depressive symptoms. and 32% reported three to five depressive symptoms. By multivariate logistic regression, patient characteristics associated with six or more symptoms of depression included < 12 Years of education, Moderate to severe limitation in functional status, and drinking more than two alcoholic beverages per day. Postoperatively, 46% of patients developed delirium. Patients with a greater number of preoperative depressive symptoms were more likely to develop postoperative delirium (p = .048) and experience a longer duration of postoperative delirium (p = .027). Even after adjusting, for covariates associated with depression and postoperative delirium-including age, educational level, functional status, and preoperative alcohol use-patients with more than six preoperative depressive symptoms were still significantly more likely to have a longer duration of postoperative delirium than did those patients with fewer than two depressive symptoms (odds ratio = 2.69, confidence interval = 1.04-6.93).Conclusion. Preoperative screening for the presence of depressive symptoms can be performed easily in elderly patients. and yields useful prognostic information relating to postoperative delirium.