Preoperative serum biomarkers in the prediction of postoperative delirium following abdominal surgery
Preoperative serum biomarkers in the prediction of postoperative delirium following abdominal surgery
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DOI：
10.1111/ggi.14066
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发表时间：
2020-10-21
影响因子：
3.3
通讯作者：
Kawaguchi, Masahiko
中科院分区：
文献类型：
--
作者：
Ida, Mitsuru;Takeshita, Yuna;Kawaguchi, Masahiko
目的老年腹部手术患者术后发生谵妄的风险较高。本研究旨在通过关注术前血液学标志物来探讨术后谵妄的危险因素，并开发一种可用于预测术后谵妄发生的模型。方法本回顾性研究纳入了2017年1月至2019年5月在全麻下接受择期腹部手术的年龄≥ 65岁的患者。记录患者的人口统计学、血液学数据和术中数据。计算中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值、血小板/白色细胞比值和预后营养指数。我们评估了术后谵妄的危险因素，使用基于图表的方法来识别谵妄，并使用术前和术中数据开发了一个预测模型。结果在931例符合条件的患者中，有833例被纳入分析，平均年龄为73.9岁。术后谵妄发生率为7.3%。年龄、手术持续时间和术前血小板与淋巴细胞比率或血小板与白色血细胞比率是具有统计学意义的危险因素。包括年龄、手术持续时间和血小板与淋巴细胞比率的预测模型的曲线下面积最大，为0.77。结论年龄、手术时间、术前血小板与白色血细胞比值或血小板与淋巴细胞比值与术后谵妄的发生有关。包括年龄、手术时间和术前血小板与淋巴细胞比率的预测模型可用于预测择期腹部手术后谵妄的发生。Geriatr Gerontol Int center dot center dot; center dot center dot：center dot center dot-center dot Geriatr Gerontol Int 2020; center dot center dot：center dot center dot-center dot center dot。
Aim Elderly patients undergoing abdominal surgery have a high risk of developing postoperative delirium. This study aimed to explore risk factors for postoperative delirium by focusing on preoperative hematologic markers, and to develop a model that would be useful in predicting the occurrence of postoperative delirium. Methods This retrospective study included patients aged >= 65 years who underwent elective abdominal surgery under general anesthesia from January 2017 to May 2019. Patients' demographics, hematologic data and intraoperative data were recorded. Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, platelet-to-white blood cell ratio and prognostic nutritional index were calculated. We evaluated risk factors of postoperative delirium assessed using a chart-based method for identification of delirium and developed a predictive model using preoperative and intraoperative data. Results Of 931 eligible patients, 833 with a mean age of 73.9 years were included in the analysis. The rate of incidence of postoperative delirium was 7.3%. Age, duration of surgery and preoperative platelet-to-lymphocyte ratio or platelet-to-white blood cell ratio were statistically significant risk factors. The predictive model, which included age, duration of surgery and platelet-to-lymphocyte ratio, had the largest area under the curve of 0.77. Conclusions Age, duration of surgery and preoperative platelet-to-white blood cell ratio or platelet-to-lymphocyte ratio are associated with the development of postoperative delirium. A predictive model, which includes age, duration of surgery and preoperative platelet-to-lymphocyte ratio, is useful in predicting the development of postoperative delirium after elective abdominal surgery.Geriatr Gerontol Int center dot center dot; center dot center dot: center dot center dot-center dot center dot Geriatr Gerontol Int 2020; center dot center dot: center dot center dot-center dot center dot.