Orotta、Halibet和Sembel医院接受脊髓麻醉的老年患者术后谵妄的发生率和危险因素:厄立特里亚的一项横断面研究

M. B. Mengistu, Yonatan Mehari Andemeske, AriamTsegay Emhatsion, HabtomTareke Wrieta, NatsnetYacob Gebreyesus
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摘要

背景:谵妄是一种常见但常被误诊的一过性症状,常见于脊柱麻醉手术后的老年患者。根据已建立的标准标准及早识别和诊断谵妄可得到改善。及早发现可能的致病因素和负担的严重程度,将有助于对脆弱的老年患者进行管理。本研究的目的是确定脊柱麻醉下手术的老年患者术后谵妄的发生率及相关危险因素。方法:本横断面研究于2019年2 - 5月在厄立特里亚阿斯马拉的国家转诊医院和Sembel私立医院进行。研究参与者为老年患者(年龄≥65岁),无已知痴呆或谵妄史,无精神障碍,无急性脑血管疾病史。收集患者的基本背景和临床特征。采用Mini Mental State Examination和Confusion Assessment Method两种工具评估患者的认知障碍程度。通过访谈法收集数据。将数据输入SPSS 22版软件后,酌情采用频率、百分比、双变量、多变量logistic回归分析方法对数据进行分析。P值<0.05为差异有统计学意义。结果:参与者平均年龄为74±6.62岁,男性102人(79.1%)。14例(10.9%)患者发生POD。调整所有潜在因素后,年龄被确定为发生POD的危险因素。结论:年龄是谵妄发生的重要危险因素。老年患者需要更多的关注和护理,研究结果可能有助于制定预防POD发生的策略
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Incidence and Risk Factors of Post-Operative Delirium in Elderly Patients Who Underwent Spinal Anesthesia in Orotta, Halibet and Sembel Hospitals: A Cross Sectional Study in Eritrea
Background: Delirium is a common but often underdiagnosed set of transient symptoms often seen in elderly patients following surgeries under spinal anesthesia. With early recognition and diagnosis based on the established standard criteria delirium can be improved. Early identification of the possible contributingfactors and the magnitude of the burden will help in the management of the fragile elderly patients. The aim of this study is to determine the incidence of postoperative delirium and associated risk factors in elderly patients who have done surgery under spinal anesthesia. Method: This cross sectional study was conducted in the National Referral Hospitals and Sembel PrivateHospital, in Asmara, Eritrea from February to May, 2019. The study participants were elderly patients (age ≥65 years) having no known history of dementia or delirium or no mental disorder, no history of acute cerebrovascular disease. Basic background and clinical characteristics of the patients was collected. To assess the status of cognitive impairment level, the Mini Mental State Examination and Confusion Assessment Method tools were used. Data was collected through an interview method. After the data was entered into SPSS version 22 software, data was analyzed with frequency, percentage, bivariate and multivariate logistic regression analysis method as appropriate. P value <0.05 was considered as statistically significant. Results: The mean age of the participants was 74 ±6.62 and 102 (79.1%) of the participants were males. POD occurred in 14 (10.9%) of the patients. Adjusting all the potential factors, age was identified as arisk factor for developing POD. Conclusion: Age was determined to be a significant risk factor of delirium. Elderly patients require more attention and care and the findings might help to develop preventive strategies to the occurrence of POD
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