Measures of executive function and depression identify patients at risk for postoperative delirium.
Measures of executive function and depression identify patients at risk for postoperative delirium.
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DOI：
10.1097/aln.0b013e31819b5ba6
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发表时间：
2009-04
期刊：
影响因子：
8.8
通讯作者：
Monk TG
中科院分区：
文献类型：
--
作者：
Greene NH;Attix DK;Weldon BC;Smith PJ;McDonagh DL;Monk TG
术后谵妄与发病率和死亡率增加有关。先前存在的认知障碍和抑郁症经常被认为是这种并发症的重要风险因素。这项前瞻性队列研究旨在确定在术前认知测试中表现不佳和/或表现出抑郁症状的个体是否具有发生术后谵妄的高风险。100名50岁及以上的非痴呆患者，计划进行重大的择期非心脏手术，完成了术前测试，包括整体认知，执行功能和抑郁症状的措施。收集已知的术前谵妄危险因素，并与术前测试组合的结果进行检查，以确定谵妄的独立预测因素。谵妄的总发生率为16%，与住院时间延长（p<0.05）和术后并发症发生率增加（p<0.01）相关。谵妄受试者与非谵妄受试者在术前整体认知功能、既存合并症、年龄、麻醉管理或饮酒史方面没有差异。分别通过连线B测试和老年抑郁量表简表测量的术前执行评分（p<0.001）和抑郁（p<0.001）被发现是术后谵妄的独立预测因素。术前低执行力评分和抑郁症状独立预测老年人术后谵妄。一个快速，简单的测试组合，包括执行功能和抑郁症的测试，可以提高医生的能力，识别患者谁可能受益于围手术期干预策略，以防止术后谵妄。
Postoperative delirium is associated with increased morbidity and mortality. Pre-existing cognitive impairment and depression have been frequently cited as important risk factors for this complication. This prospective cohort study was designed to determine if individuals who perform poorly on preoperative cognitive tests and/or exhibited depressive symptoms would be at high risk for the development of postoperative delirium. One hundred nondemented patients, 50 years and older, scheduled for major, elective noncardiac surgery completed a preoperative test battery that included measures of global cognition, executive function and symptoms of depression. Known preoperative risk factors for delirium were collected and examined with the results of the preoperative test battery to determine the independent predictors of delirium. The overall incidence of delirium was 16% and was associated with increased hospital length of stay (p<0.05) and an increased incidence of postoperative complications (p<0.01). Delirious subjects did not differ from their non-delirious cohorts with regard to their preoperative global cognitive function, preexisting medical comorbidities, age, anesthetic management or history of alcohol use. Preoperative executive scores (p<0.001) and depression (p<0.001), as measured by the Trail Making B test and Geriatric Depression Scale Short Form, respectively, were found to be independent predictors of postoperative delirium. Low preoperative executive scores and depressive symptoms independently predict postoperative delirium in older individuals. A rapid, simple test combination including tests of executive function and depression could improve physicians’ ability to recognize patients who might benefit from a perioperative intervention strategy to prevent postoperative delirium.
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影响因子：
9.9
作者：
Elkins, J. S.;Longstreth, W. T., Jr.;Johnston, S. C.
通讯作者：
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