老年医学与保健2025，Vol.31Issue(2)：395-399,5.
基于老年患者的围手术期临床特征预测全麻术后认知功能障碍发生风险的分析
Analysis of prediction of risk of cognitive dysfunction after general anesthesia based on perioperative clinical characteristics in elderly patients
摘要
Abstract
Objective To identify risk factors for postoperative cognitive dysfunction(POCD)in elderly patients after general anesthesia and establish a risk score calculation formula to evaluate its predictive efficacy.Methods A retrospective study was conducted on 321 elderly patients who underwent general anesthesia in People's Hospital of Hai'an City from January 2021 to October 2023.Their cognitive function was assessed by the Montreal Cognitive Assessment(MoCA)scale,and then they were divided into cognitive dysfunction group(POCD group,n=107)and normal cognitive function group(non-POCD group,n=214).Their clinical data were collected.Univariate Logistic regression was used to screen risk factors and protective factors.Multivariate Logistic regression was used to identify independent risk factors.Receiver operating characteristic(ROC)curves were used to evaluate the predictive performance of these factors for POCD.Results Increased age,hypertension histo-ry,diabetes history,prolonged anesthesia duration and postoperative infection were identified as risk factors for POCD,while postoperative analgesia served as a protective factor.Age and postoperative infection were independent risk factors for POCD,and postoperative analgesia was an independent protective factor.The risk score calculation formula was defined as:Risk score=1.15+0.54 × age-0.25 × postoperative analgesia+0.12 × postoperative infection.ROC curve analysis showed that the area under the curve of age,postoperative analgesia,postoperative infection and risk score were 0.72(P=0.004),0.63(P=0.041),0.57(P=0.038)and 0.81(P=0.002),respectively.Conclusion Increased age and postoperative infection are independent risk factors for POCD in elderly patients,while postoperative analgesia is a protective factor.Risk scores may have good predictive efficacy for POCD in elderly patients.关键词
老年/认知功能障碍/全麻/术后感染/MoCA评分/年龄/术后镇痛Key words
elderly/cognitive dysfunction/general anesthesia/postoperative infection/MoCA score/age/postopera-tive analgesia引用本文复制引用
于梦涵,王祥,陈为国,郭宗锋..基于老年患者的围手术期临床特征预测全麻术后认知功能障碍发生风险的分析[J].老年医学与保健,2025,31(2):395-399,5.基金项目
海安市科技局南通市科技计划项目(JCZ2022014) （JCZ2022014）
