ICU老年脑出血患者术后谵妄发生情况及危险因素分析OACSTPCD
Analysis of postoperative delirium and its risk factors in elderly patients with cerebral hemorrhage in ICU
目的 分析重症加强护理病房(ICU)老年脑出血患者术后谵妄(POD)发生情况和危险因素.方法 回顾性分析2020 年1 月—2023 年1 月于新疆医科大学第一附属医院ICU行脑出血手术的 80 例患者的临床资料,根据患者POD发生情况将其分为POD组(n =34)和无POD组(n =46).对比POD组和无POD组患者的一般资料,手术时间、麻醉持续时间、术中最低平均动脉压,患者术后低氧血症比例、机械通气比例、术后带管时间和术后格拉斯哥昏迷评分(GCS);采用Logistic回归分析ICU老年脑出血患者发生POD的危险因素;采用ROC曲线分析相关因素对脑出血患者发生POD的预测价值.结果 80 例ICU老年脑出血患者POD发生率为42.50%(34/80);与无POD组相比,POD组平均年龄更高,平均住院时间、糖尿病例数占比、手术时间、脑出血量、麻醉持续时间、术后低氧血症例数占比、机械通气例数占比和术后带管时间均更高,术中最低平均动脉压和术后GCS评分均更低,差异均有统计学意义(P＜0.05).Logistic回归分析显示,年龄过大、术后发生低氧血症、GCS评分过低和脑出血量过多是老年ICU脑出血患者发生POD的危险因素(P＜0.05).ROC曲线分析显示,年龄(AUC =0.779)、术后低氧血症(AUC =0.734)、GCS评分(AUC =0.781)和脑出血量(AUC =0.711)均能较好的预测脑出血患者POD的发生情况(P＜0.05).结论 年龄过大、术后发生低氧血症、GCS评分过低和脑出血量过多均可能促使ICU老年脑出血患者发生POD.
Objective To analyze the occurrence and risk factors of postoperative delirium(POD)in elderly patients with cerebral hemorrhage in intensive care unit(ICU).Methods The clinical data of 80 patients who underwent cerebral hemorrhage surgery in ICU of First Affiliated Hospital of Xinjiang Medical University from January 2020 to January 2023 were retrospectively analyzed.They were divided into POD group(n =34)and non-POD group(n =46)according to the occurrence of POD.The general data,operation time,duration of anesthesia,minimum mean intraoperative arterial pressure,postoperative hypoxemia rate,mechanical ventilation rate,postoperative catheter time and postoperative Glasgow Coma score(GCS)were compared be-tween the two groups.Logistic regression was used to analyze the risk factors for POD in elderly ICU patients with cerebral hem-orrhage.ROC curve was used to analyze the predictive value of related factors for POD occurrence in patients with cerebral hem-orrhage.Results The incidence of POD in 80 elderly ICU patients with cerebral hemorrhage was42.50%(34/80).Compared with the non-POD group,the average age of the POD group was higher.The average hospital stay,the proportion of diabetes pa-tients,operation time,cerebral hemorrhage volume,duration of anesthesia,the proportion of postoperative hypoxemia patients and mechanical ventilation patients,and postoperative catheter time were higher/longer,and the minimum mean arterial pressure and postoperative GCS score were lower,with statistical significance(P＜0.05).Logistic regression analysis showed that ad-vanced age,postoperative hypoxemia,low GCS score and excessive intracerebral hemorrhage were risk factors for POD in elderly ICU patients(P＜0.05).ROC curve analysis showed that age(AUC =0.779),postoperative hypoxemia(AUC =0.734),GCS score(AUC =0.781),and cerebral hemorrhage volume(AUC =0.711)could predict the occurrence of POD in patients with cerebral hemorrhage(P＜0.05).Conclusion Advanced age,postoperative hypoxemia,low GCS score,and excessive cerebral hemorrhage may all contribute to the development of POD in elderly ICU patients with cerebral hemorrhage.
马娇;左蕾;热依拉·艾力;张文玲;程娜
新疆医科大学第一附属医院创伤重症科,新疆乌鲁木齐 830000
老年脑出血重症加强护理病房术后谵妄危险因素
elderlycerebral hemorrhageintensive care unitpostoperative deliriumrisk factor
《老年医学与保健》 2024 (002)
343-347 / 5
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