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《Journal of Clinical Anesthesiology》 2013-08
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Risk factors of post-operative delirium and cognitive dysfunction in elderly patients undergoing hip joint replacement surgery

WANG Bin, ZHANG Qi-liang, LI Jun, LIU Shu-yun, BI Yan-lin.Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao 266071, China  
Objective To determine the risk factors for post-operative delirium(POD) and post-operative cognitive dysfunction(POCD) in elderly patients undergoing hip joint replacement surgery.Methods We selected 200 elderly patients under epidural anesthesia and scheduled for hip joint replacement surgery from 2010 to 2012 in Qingdao Municipal Hospital. POD was assessed by confusion assessment method(CAM) at 2 days after operation.Cognitive function was assessed by Mini-Mental State Examination(MMSE),at 7 days after operation. The factor was analyzed using multi-factor logistic regression to select risk factor for incidence of POD and POCD.Results Thirty-one patients developed POD(15.5%).Fifty-six patients developed POCD(28.0%).The results of multivariate logistic analysis showed that the risk factors for POD were the age75 years old (OR 1.88,95%CI 1.48-3.23), injury time15 h(OR 1.63,95%CI 1.01-3.15), education9 years (OR 2.73,95%CI 1.27-5.78) preoperative depression(OR 1.61,95%CI 1.06-2.65), diabetes (OR 1.43,95%CI 1.24-3.19), intraoperative hypotension (OR 1.23,95%CI 1.05-2.75);and risk factors for POCD were the age80 years old(OR 1.77,95%CI 1.11-3.54),injury time15 h(OR 1.22,95%CI 1.14-2.51), intraoperative hypotension(OR 1.14,95%CI 1.01-3.15), preoperative depression(OR 1.14,95%CI 1.02-2.90),alcohol comsumption per week5 Units(OR 2.14,95%CI 1.27-4.65),education12 years(OR 2.97,95%CI 1.81-3.15),diabetes(OR 1.13,95%CI 1.04-3.47),VAS score4(OR 1.37,95%CI 1.19-3.49).Conclusion Age, injury time, preoperative depression, years of education,diabetes and intraoperative hypotension were the common risk factors for postoperative delirium and postoperative cognitive dysfunction.
【Fund】: 青岛市科技局科技发展计划资助项目(10-3-3-4-8nsh)
【CateGory Index】: R614
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【Co-citations】
Chinese Journal Full-text Database 2 Hits
1 SU Han;ZHANG Jie;Department of Anesthesiology,Honghui Affiliated Hospital of Medical College of Xi’an Jiao Tong University;;A Comparative Study of Influence of Two Different Anesthesia Methods on Postoperative Short-Term Cognitive Function in Elderly Patients with Orthopedic Diseases[J];Chinese Journal of General Practice;2013-09
2 WANG Weiping Taiyuan Teachers College,Taiyuan 030012,China;Influencing Factors on Postoperative Cognitive Dysfunction in Elderly Patients[J];China Modern Doctor;2010-22
【Secondary Citations】
Chinese Journal Full-text Database 2 Hits
1 Zhao Hong,Zhang Li(Yutai People's Hospital,Yutai Shandong 272300,China);Effect of cognitive nursing therapy on the postoperative elderly patients with general anesthesia.[J];Journal of Qilu Nursing;2005-01
2 LIAO Huihua,ZHANG Zhijian,HE Qixia,MO Jian(Department of Anesthesiology,Affiliated Hospital of Guangdong Medical College,Zhanjiang 524001,China);Study on the Influence of Different Anesthesiasenile Methods to Senile Patients about Early Postoperative Cognition[J];Clinical Medicine & Engineering;2010-05
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