老年患者低体重指数增加术后谵妄风险:前瞻性队列研究

被引：29

作者：

苏仙

王东信

孟昭婷

机构：

[1] 北京大学第一医院麻醉科

来源：

临床麻醉学杂志 | 2015年 / 31卷 / 05期

关键词：

老年; 体重指数; 谵妄; 危险因素;

D O I：

暂无

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

目的分析老年患者术后谵妄的危险因素,探究体重指数(BMI)与老年患者术后谵妄的关系。方法本研究为前瞻、观察性队列研究。2011年5月至2013年11月全身麻醉下接受非心脏手术后入ICU的老年患者350例,年龄≥65岁。使用CAM-ICU法每天2次评估术后7d内谵妄发生情况。使用Logistic多因素回归分析评估术后谵妄的危险因素。结果共79例(22.6%)患者发生术后谵妄。参照WHO亚洲人BMI参考标准,将患者分为偏瘦(BMI<18.5kg/m2)、正常(BMI18.5～22.9kg/m2)、偏胖(BMI 23.0～24.9kg/m2)、肥胖(BMI 25.0～29.9kg/m2)、重度肥胖(BMI≥30.0kg/m2)5个等级,将BMI分级代入Logistic多因素回归模型,结果显示与正常BMI者比较,偏瘦者术后谵妄风险增加(OR 2.551,95%CI 1.101～5.909,P=0.029),而偏胖、肥胖与重度肥胖者不增加术后谵妄风险。对BMI进行ROC曲线分析,得出谵妄风险增加的拐点BMI为20.0kg/m2,根据此拐点将BMI转换为二分类变量并代入Logistic多因素回归模型,结果显示BMI<20.0kg/m2者术后谵妄发生风险明显增加(OR 2.679,95%CI 1.438～4.990,P=0.001)。结论对于非心脏手术后进入ICU的老年患者,低体重指数(BMI<20.0kg/m2)是增加术后谵妄风险的独立危险因素之一。

引用

页码：421 / 426

页数：6

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