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危重患者术后谵妄对远期生存率的影响

刘丹 王东信

重庆医学Issue(9):1229-1231,3.
重庆医学Issue(9):1229-1231,3.DOI:10.3969/j.issn.1671-8348.2015.09.025

危重患者术后谵妄对远期生存率的影响

The impact of postoperative delirium on long-term survival rate in severe patient after surgery

刘丹 1王东信2

作者信息

  • 1. 北京肿瘤医院麻醉科 100142
  • 2. 北京大学第一医院麻醉科 100034
  • 折叠

摘要

Abstract

Objective To identify the influence of early postoperative delirium on long-term morbidity ,mortality and quality of life(QoL) .Methods 261 patients admitting to SICU after noncardiac surgery were prospectively included .The clinical data were collected .Delirium was diagnosed clinically by Confusion Assessment Method-Intensive Care Unit(CAM-ICU) .The patients were followed 2 years after the surgery and the quality of life was assessed by three scales .Results The incidence of early PD was 21 .8% .Multivariate logistic regression analysis showed that increasing age ,shorter educational time ,preoperative diabetes melli-tus ,high ASA grades and high APACHE II score on SICU admission were the independent predictors for early PD .The cumulative survival in 24 months was 66 .5% in patients without delirium and 57 .3% in patients with delirium ,there was no statistical differ-ence between two groups(P=0 .187) .Multivariable Cox model showed that male patients ,tumor stage ≥3 and high ASA grades were the independent predictors for postoperative death .The long-term QoL in delirious patients were significant poorer than that in non-delirious patients in mainly four domains :physical function ,role-physical ,social function and cognitive function .Conclusion Early postoperative delirium significantly deteriorate the long-term quality of life in severe patient after noncardiac surgery in mainly four domains :physical function ,role-physical ,social function and cognitive function .

关键词

谵妄/生存质量/生存率

Key words

delirium/quality of life/survival rate

分类

医药卫生

引用本文复制引用

刘丹,王东信..危重患者术后谵妄对远期生存率的影响[J].重庆医学,2015,(9):1229-1231,3.

重庆医学

OA北大核心CSTPCD

1671-8348

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