Baseline cerebral oximetry values in elderly patients with hip fractures: A prospective observational study
Baseline cerebral oximetry values in elderly patients with hip fractures: A prospective observational study
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DOI：
10.1016/j.injury.2011.04.015
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发表时间：
2011-11-01
影响因子：
2.5
通讯作者：
Berris, Alexandros
中科院分区：
文献类型：
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作者：
Papadopoulos, Georgios;Karanikolas, Menelaos;Berris, Alexandros
目的：本研究旨在评估老年髋部骨折患者脑组织局部血氧饱和度(RSO(2))的基线值，并找出与RSO(2)严重降低相关的危险因素。这项研究得到了机构伦理委员会的批准，所有患者在进入研究之前都签署了知情同意书。收集了可能与基线脑RSO相关的因素的数据(2)。数据分析采用t检验、皮尔逊相关或多元回归分析。结果：69例患者，年龄(均数+/-标准差)74+/-13岁。左侧RSO(2)为60.09+/-10.20，右侧RSO(2)为58.64+/-9.92。基线RSO(2)和45在左侧占10.1%，右侧占8.7%。左侧和右侧基线脑RSO(2)的相关性非常显著(r=0.852，p<；0.001)。术前脑RSO(2)与术前红细胞压积(r=0.5，p<；0.001)、动脉血氧饱和度(Spo(2))呈高度正相关(r=0.587，p<；0.001)，与美国麻醉医师协会的身体状况(r=-0.42，p<；0.001)、年龄(r=-0.39，p=0.001)呈负相关。线性回归分析显示，术前红细胞压积对RSO(2)变异的贡献率为23%(R2=0.23)，而术前红细胞压积和SpO(2)合计对RSO(2)变异的贡献率为43.7%(R2=0.437)。术前红细胞压积+SpO(2)+AGE合计占观察到的RSO(2)变异的51.3%(R2=0.513)。结论：尽管血液动力学和动脉饱和度正常，但老年髋部骨折患者的基础脑部RSO(2)值普遍较低。术前红细胞压积、SpO(2)和年龄解释了脑RSO(2)变异性的重要部分。需要更多的研究来验证我们的发现，并评估旨在改善老年髋部骨折患者大脑RSO的干预措施的潜在益处。(C)2011爱思唯尔有限公司。保留所有权利。
Aim: This study was conducted to evaluate baseline cerebral tissue regional oxygen saturation (rSO(2)) values and identify risk factors related to severe rSO(2) reductions in elderly patients with hip fractures.Patients and methods: This was a prospective observational single-centre study on patients undergoing scheduled or urgent operation for isolated hip fracture. The study was approved by the Institution Ethics Committee, and all patients signed informed consent before entering the study. Data were collected on factors potentially related to baseline cerebral rSO(2). Data were analysed with Student's t-test, Pearson's correlation or multiple regression analysis as appropriate.Results: Sixty-nine patients, aged (mean +/- standard deviation (SD)) 74 +/- 13 years participated. Left baseline rSO(2) was 60.09 +/- 10.20 and right baseline rSO(2) was 58.64 +/- 9.92. Baseline rSO(2) < 45 was observed in 10.1% of patients on the left and 8.7% on the right side. Correlation between left-and right-side baseline cerebral rSO(2) was highly significant (r = 0.852, p < 0.001). Baseline cerebral rSO(2) had a positive, highly significant correlation with preoperative haematocrit (r = 0.50, p < 0.001) and arterial haemoglobin oxygen saturation (SpO(2)) (r = 0.587, p < 0.001), but correlation was negative with the American Society of Anesthesiologists (ASA) physical status (r = -0.42, p < 0.001) and age (r = -0.39, p = 0.001). Linear regression showed that preoperative haematocrit accounts for 23% (R-2 = 0.23) of baseline rSO(2) variability, whereas preoperative haematocrit and SpO(2) combined account for 43.7% of rSO(2) variability (R-2 = 0.437). Combined preoperative haematocrit + SpO(2) + age accounted for 51.3% (R-2 = 0.513) of observed rSO(2) variability.Conclusion: Low baseline cerebral rSO(2) values are common in elderly hip fracture patients, despite normal haemodynamic and arterial saturation values. Preoperative haematocrit, SpO(2) and age explain a significant portion of cerebral rSO(2) variability. More studies are needed to validate our findings and assess the potential benefit of interventions aimed at improving cerebral rSO(2) in elderly hip fracture patients. (C) 2011 Elsevier Ltd. All rights reserved.