Sensitivity and specificity of the animal fluency test for predicting postoperative delirium.
Sensitivity and specificity of the animal fluency test for predicting postoperative delirium.
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DOI：
10.1007/s12630-014-0306-7
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发表时间：
2015-06
期刊：
影响因子：
--
通讯作者：
Leung JM
中科院分区：
文献类型：
--
作者：
Long LS;Wolpaw JT;Leung JM
术前认知功能障碍是术后谵妄的主要危险因素。因此，我们研究了在手术前进行简短的认知筛查的预后意义和可行性。患者年龄> 65岁，接受髋关节、膝关节或脊柱手术。术前进行60秒的认知筛查，即动物流畅性测试（AFT）。术后谵妄使用基于图表的工具进行测量，该工具先前使用混乱评估方法的标准进行了验证。在符合入选/排除标准的362例患者中，199例（55%）接受了AFT。其中，57名患者（29%）的AFT评分< 15，38名患者（19%，95%置信区间[CI]：14 - 25%）发生术后谵妄，通过病历审查进行测量。评分< 15分的患者发生术后谵妄的可能性高于评分≥ 15分的患者（54%比5%，P < 0.01）。以术后谵妄为因变量的多元logistic回归分析发现，AFT评分< 15（优势比20.1，95% CI：7.9 - 51.4）和美国麻醉医师协会高分级（优势比3.5，95% CI：1.3 - 9.2）为独立预测因素。AFT是一种潜在有用的简短认知筛查，可用于识别有发生术后谵妄风险的患者。然而，本研究中合格参与者的有限参与提出了关于系统管理测试的有用性和可行性的问题。采用前瞻性测量术后谵妄的大型研究表明，以验证我们的结果。
Preoperative cognitive impairment is a major risk factor for postoperative delirium. We therefore investigated the prognostic significance and feasibility of administering a brief cognitive screen before surgery. Patients > 65 yr of age undergoing hip, knee, or spine surgery were enrolled. A 60-sec cognitive screen, the animal fluency test (AFT), was administered preoperatively. Postoperative delirium was measured using a chart-based tool previously validated using criteria from the Confusion Assessment Method. Of the 362 patients satisfying the inclusion/exclusion criteria, 199 (55%) underwent the AFT. Among them, 57 patients (29%) had an AFT score < 15, and 38 patients (19%, 95% confidence interval [CI]: 14 to 25%) developed postoperative delirium as measured by chart review. Patients with scores of < 15 were more likely to develop postoperative delirium than those who scored ≥ 15 (54% vs 5%, P < 0.01). A multiple logistic regression, with postoperative delirium as the dependent variable, identified an AFT score of < 15 (odds ratio 20.1, 95% CI: 7.9 to 51.4) and high American Society of Anesthesiologists classification (odds ratio 3.5, 95% CI: 1.3 to 9.2) as independent predictors. The AFT is a potentially useful brief cognitive screen for identifying patients at risk of developing postoperative delirium. Limited participation by eligible participants in this study, however, raises questions about how useful and feasible systematic administration of the test is. Large studies using prospective measurement of postoperative delirium are indicated to validate our results.
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DOI：
10.1007/s12630-014-0242-6
发表时间：
2014-12
期刊：
Canadian journal of anaesthesia = Journal canadien d'anesthesie
影响因子：
--
作者：
Youngblom E;DePalma G;Sands L;Leung J
通讯作者：
Leung J
DOI：
10.1111/j.1532-5415.2005.53269.x
发表时间：
2005-05-01
影响因子：
6.3
作者：
Borson, S;Scanlan, JM;Lessig, M
通讯作者：
Lessig, M
影响因子：
6.3
作者：
Saczynski JS;Kosar CM;Xu G;Puelle MR;Schmitt E;Jones RN;Marcantonio ER;Wong B;Isaza I;Inouye SK
通讯作者：
Inouye SK
DOI：
10.1111/j.1532-5415.2005.53120.x
发表时间：
2005-02-01
影响因子：
6.3
作者：
Inouye, SK;Leo-Summers, L;Agostini, JV
通讯作者：
Agostini, JV
影响因子：
9
作者：
Böhner, H;Hummel, TC;Schneider, F
通讯作者：
Schneider, F