麻醉技术与全膝关节或髋关节置换术后谵妄的发生率:一项全国性队列研究。

IF 2.3 3区 医学 Q2 ANESTHESIOLOGY
Hey-Ran Choi, Saeyeon Kim, In-Ae Song, Tak Kyu Oh
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引用次数: 0

摘要

背景:减少术后谵妄的最佳麻醉类型仍未确定。本研究旨在评估麻醉类型与术后谵妄之间的关系:这项回顾性全国队列研究使用了 2016 年至 2021 年期间从韩国国民健康保险服务机构收集的数据。研究纳入了在全身麻醉或区域麻醉下接受初级全髋关节或全膝关节置换术的成年患者。根据《国际疾病分类》第 10 次修订版的谵妄代码(F05),确定了关节置换术后出现术后谵妄的患者。患者分为两组:区域麻醉组(RA 组)和全身麻醉组(GA 组)。主要终点是全髋关节或膝关节置换术后住院期间术后谵妄的发生率:我们的研究样本包括 664,598 名患者:结果:我们的研究样本包括 664,598 名患者:RA 组 474,932 人,GA 组 189,666 人。经过倾向评分(PS)匹配后,276,582 名患者(每组 138,291 人)被纳入最终分析。在 PS 匹配队列中,GA 组全膝关节或全髋关节置换术后谵妄的发生率为 2.8%(3842/138291),RA 组为 2.3%(3147/138291)。在逻辑回归中,RA 组的相关性为 18%(几率比:0.82,95% 置信区间:0.78,0.86;P 结论:RA 组的相关性为 18%(几率比:0.82,95% 置信区间:0.78,0.86):与全身麻醉相比,区域麻醉可降低全髋关节或全膝关节置换术患者术后谵妄的发生率。我们的研究结果表明,避免全身麻醉可预防下肢手术后谵妄。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Anesthetic technique and incidence of delirium after total knee or hip arthroplasty: a nationwide cohort study.

Background: The optimal type of anesthesia for reducing postoperative delirium remains undetermined. This study aimed to assess the relationship between type of anesthesia and postoperative delirium.

Methods: This retrospective national cohort study used data collected between 2016 and 2021 from the National Health Insurance Service of South Korea. Adult patients who underwent primary total hip or total knee arthroplasty under general or regional anesthesia were included. Patients with postoperative delirium were identified after arthroplasty according to the International Classification of Diseases 10th revision code for delirium (F05). The patients were divided into two groups: regional anesthesia (RA group) and general anesthesia (GA group). The primary endpoint was the incidence of postoperative delirium during hospitalization after total hip or knee arthroplasty.

Results: Our study sample consisted of 664,598 patients: 474,932 in the RA group and 189,666 in the GA group. After propensity score (PS) matching, 276,582 patients (138,291 in each group) were included in the final analysis. In the PS-matched cohort, the incidence of delirium following total knee or total hip arthroplasty was 2.8% (3,842/138,291) in the GA group and 2.3% (3,147/138,291) in the RA group. In logistic regression, the RA group was associated with 18% (odds ratio: 0.82, 95% confidence interval: 0.78, 0.86; P < 0.001) lower postoperative incidence than the GA group.

Conclusion: Compared to general anesthesia, regional anesthesia was associated with a decreased incidence of postoperative delirium in patients who underwent total hip or total knee arthroplasty. Our findings indicate that avoiding general anesthesia may prevent delirium after lower limb surgery.

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来源期刊
BMC Anesthesiology
BMC Anesthesiology ANESTHESIOLOGY-
CiteScore
3.50
自引率
4.50%
发文量
349
审稿时长
>12 weeks
期刊介绍: BMC Anesthesiology is an open access, peer-reviewed journal that considers articles on all aspects of anesthesiology, critical care, perioperative care and pain management, including clinical and experimental research into anesthetic mechanisms, administration and efficacy, technology and monitoring, and associated economic issues.
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