INDEPENDENT ASSOCIATION BETWEEN PREOPERATIVE COGNITIVE STATUS AND DISCHARGE LOCATION AFTER CARDIAC SURGERY
INDEPENDENT ASSOCIATION BETWEEN PREOPERATIVE COGNITIVE STATUS AND DISCHARGE LOCATION AFTER CARDIAC SURGERY
复制标题
DOI：
10.4037/ajcc2011275
复制
发表时间：
2011-03-01
影响因子：
2.7
通讯作者：
Rudolph, James L.
中科院分区：
文献类型：
--
作者：
Harrington, Mary Beth;Kraft, Malissa;Rudolph, James L.
背景在心脏手术患者中，术前认知功能受损的患者可能比正常患者术后住院时间更长，出院时可能需要额外的护理。（The Clock-in-the-Box）与心脏手术患者术后住院时间和出院到家以外的地方有关。作为术前评估的一部分，对计划在单个中心进行心脏手术的患者进行了Clock-in-the-Box给药。从病历中回顾性收集了Clock-in-the-Box工具、人口统计学和手术信息、术后住院时间和出院地点的评分。结果患者的平均年龄为68.1岁（SD，0.7），99%为男性。平均术后住院时间为10.5天（SD，8.2），35例患者（19%）出院。Clock-in-the-Box评估评分与术后住院时间无关。年龄增加、术前独居和体外循环时间与出院相关，并作为校正分析的协变量。调整后，更好的术前认知状态降低被出院到设施的风险（调整后的相对危险度，0.93; 95%置信区间，0.89-0.98）后心脏surgery.Conclusions心脏手术前的认知筛查可以识别患者的认知功能受损的状态是不太可能比正常的认知状态的患者心脏手术后回家。（American Journal of Critical Care）2011;20：129-137）
Background Among cardiac surgery patients, those with impaired cognitive status before surgery may have longer postoperative stays than do patients with normal status and may require additional care upon discharge.Objectives To determine if preoperative scores on a screening measure for cognitive status (the Clock-in-the-Box), were associated with postoperative length of stay and discharge to a location other than home in patients who had cardiac surgery.Methods A total of 181 consecutive patients scheduled for cardiac surgery at a single site were administered the Clock-in-the-Box as part of the preoperative evaluation. Scores on the Clock-in-the-Box tool, demographic and operative information, postoperative length of stay, and discharge location were collected retrospectively from medical records.Results The mean age of the patients was 68.1 years (SD, 0.7), and 99% were men. Mean postoperative length of stay was 10.5 days (SD, 8.2), and 35 patients (19%) were discharged to a facility. Scores on the Clock-in-the-Box assessment were not associated with postoperative length of stay. Increasing age, living alone before surgery, and duration of cardiopulmonary bypass were associated with discharge to a facility and were used as covariates in adjusted analyses. After adjustment, better preoperative cognitive status reduced the risk of being discharged to a facility (adjusted relative risk, 0.93; 95% confidence interval, 0.89-0.98) after cardiac surgery.Conclusions Cognitive screening before cardiac surgery can identify patients with impaired cognitive status who are less likely than patients with normal cognitive status to return home after cardiac surgery. (American Journal of Critical Care. 2011;20:129-137)