Relationship between modified Frailty Index and development of delirium after artificial joint replacement in elderly patients

Q4 Medicine 中华麻醉学杂志 Pub Date : 2019-10-20 DOI:10.3760/CMA.J.ISSN.0254-1416.2019.10.003

F. Cui, Wei Zhao, Chun-jing Li, D. Mu

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引用次数: 1

Abstract

Objective To evaluate the relationship between modified Frailty Index (mFI) and development of delirium after artificial joint replacement in elderly patients. Methods Elderly patients (aged ≥60 yr) who scheduled for elective hip or knee replacement, were enrolled.Preoperative frailty was assessed using the mFI scale.All the patients received surgery under combined spinal-epidural anesthesia.Primary outcome was the incidence of delirium within 5 days after operation, and delirium was assessed by Confusion Assessment Method or Confusion Assessment Method-Intensive Care Unit.The patients were divided into delirium group and non-delirium group according to whether delirium occurred or not. Results A total of 620 patients were included in the study, the mFI was 0.09 (0.18), and the incidence of delirium within 5 days after surgery was 8.5%.The results of multivariate logistic regression analyses showed that increase in age (OR 1.068, 95% CI 1.018-1.120, P=0.007), higher postoperative consumption of morphine (OR 1.089, 95% CI 1.051-1.128, P<0.01) and higher mFI (OR 2.465, 95% CI 1.636-3.714, P<0.01) were the independent risk factors for postoperative delirium. Conclusion Higher mFI is the independent risk factor for delirium after artificial joint replacement in elderly patients. Key words: Arthroplasty, replacement; Aged; Delirium; Modified frailty index

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老年人工关节置换术后衰弱指数与谵妄发生的关系

目的探讨改良虚弱指数（mFI）与老年人工关节置换术后谵妄发生的关系。方法选择计划择期髋关节或膝关节置换术的老年患者（年龄≥60岁）。使用mFI量表评估术前虚弱程度。所有患者均在腰麻-硬膜外联合麻醉下接受手术。主要结果是术后5天内发生谵妄，采用困惑评估法或困惑评估法重症监护室评估谵妄。根据是否发生谵妄将患者分为谵妄组和非谵妄组。结果本研究共纳入620例患者，mFI为0.09（0.18），术后5天内谵妄发生率为8.5%。多元逻辑回归分析结果显示，年龄增加（OR 1.068，95%CI 1.018-1.120，P=0.007），术后较高的吗啡消耗量（OR 1.089，95%CI 1.051-1.128，P<0.01）和较高的mFI（OR 2.465，95%CI 1.636-3.714，P<0.01）是术后谵妄的独立危险因素。结论较高的mFI是老年人工关节置换术后发生谵妄的独立危险因素。关键词：关节成形术、置换术；老年人；谵妄；改良虚弱指数

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