Long-term postoperative cognitive dysfunction in the elderly: ISPOCD1 study
Long-term postoperative cognitive dysfunction in the elderly: ISPOCD1 study
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DOI：
10.1016/s0140-6736(97)07382-0
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发表时间：
1998-03-21
期刊：
影响因子：
168.9
通讯作者：
Gravenstein, JS
中科院分区：
文献类型：
--
作者：
Moller, JT;Cluitmans, P;Gravenstein, JS
背景 老年人可能会出现长期术后认知功能障碍。年龄可能是一个危险因素，也是低氧血症和动脉低血压的致病因素。我们在一项国际多中心研究中对这些假设进行了调查。方法 1218 名年龄至少 60 岁的患者在重大非心脏手术前、术后 1 周和 3 个月完成了神经心理学测试。我们在术前、术中全天和术后前 3 个晚上通过连续脉搏血氧饱和度测量血氧饱和度。我们在手术期间每 3 分钟用示波法记录一次血压，在当天和晚上的其余时间里每 15-30 分钟记录一次血压。我们通过神经心理学测试确定术后认知功能障碍，并与从英国 (n=176) 和研究中心相同国家 (n=145) 招募的对照组进行比较。结果 与对照组相比，术后 1 周有 266 名 (25.8% [95% CI 23.1-28.5]) 患者出现术后认知功能障碍，术后 3 个月有 94 名 (9.9% [8.1-12.0]) 患者出现术后认知功能障碍。英国控制的比例分别为 3.4% 和 2.8%（p
Background Long-term postoperative cognitive dysfunction may occur in the elderly. Age may be a risk factor and hypoxaemia and arterial hypotension causative factors. We investigated these hypotheses in an international multicentre study.Methods 1218 patients aged at least 60 years completed neuropsychological tests before and 1 week and 3 months after major non-cardiac surgery. We measured oxygen saturation by continuous pulse oximetry before surgery and throughout the day of and the first 3 nights after surgery. We recorded blood pressure every 3 min by oscillometry during the operation and every 15-30 min for the rest of that day and night. We identified postoperative cognitive dysfunction with neuropsychological tests compared with controls recruited from the UK (n=176) and the same countries as study centres (n=145).Findings Postoperative cognitive dysfunction was present in 266 (25.8% [95% CI 23.1-28.5]) of patients 1 week after surgery and in 94 (9.9% [8.1-12.0]) 3 months after surgery, compared with 3.4% and 2.8%, respectively, of UK controls (p