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https://ir.cnu.edu.tw/handle/310902800/32504
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| 標題: | Intraoperative blood transfusion predicts postoperative delirium among older patients undergoing elective orthopedic surgery: A prospective cohort study |
| 作者: | Ming-Yueh Chou(周明岳)
Wang, Yu-Chun
Peng, Li-Ning
Liang, Chih-Kuang
Chu, Che-Sheng
Liao, Mei-Chen
Lin, Yu-Te
Hsu, Chien-Jen
Liang-Kung Chen(陳亮恭) |
| 貢獻者: | Kaohsiung Vet Gen Hosp, Ctr Geriatr & Gerontol
Natl Yang Ming Univ, Aging & Hlth Res Ctr
Natl Yang Ming Univ, Sch Med, Dept Geriatr Med
Chia Nan Univ Pharm & Sci
Taipei Vet Gen Hosp, Ctr Geriatr & Gerontol
Kaohsiung Vet Gen Hosp, Div Neurol, Dept Med
Kaohsiung Vet Gen Hosp, Dept Psychiat
Kaohsiung Vet Gen Hosp, Dept Orthoped |
| 關鍵字: | anemia
blood transfusion
delirium
elective orthopedic surgery |
| 日期: | 2019-06 |
| 上傳時間: | 2020-07-29 13:47:41 (UTC+8) |
| 出版者: | WILEY |
| 摘要: | Objectives To evaluate the roles of preoperative anemia and intraoperative blood transfusion in the development of postoperative delirium among older patients undergoing elective orthopedic surgery. Methods This prospective cohort study recruited subjects aged 60 years old and above who were admitted for elective orthopedic surgery in a tertiary medical center during April 2011 to December 2013. Demographic data (age, gender, body mass index [BMI], and educational level), surgery-related factors (American Society of Anesthesiology [ASA] class, type of anesthesia and surgery, and intraoperative blood transfusion), results of geriatric assessment (hearing/visual impairment, cognition, depressive mood, comorbidity, malnutrition, polypharmacy, activities of daily living [ADL], and instrumental activities of daily living [IADL]), laboratory data, length of hospital stay, and the development of postoperative delirium were collected for analysis. Results Overall, 461 patients (mean age: 73.5 +/- 7.5 years, 42.1% males) were enrolled for study, and 37 (8.0%) of them developed postoperative delirium. We categorized all subjects into four groups based on anemia on admission and blood transfusion during operation or not. Multivariate logistic regression showed that subjects with anemia on admission and received intraoperative blood transfusion were at higher risk of developing postoperative delirium (adjusted odds ratio 3.090; 95% confidence interval [CI], 1.070-8.926) and those without anemia on admission but received intraoperative blood transfusion were at marginal risk (adjusted odds ratio 2.906; 95% CI, 0.912-9.259) after adjustment for covariates. Conclusions Anemic older patients receiving intraoperative blood transfusion during operation were at the greatest risk for postoperative delirium when they underwent elective orthopedic surgery. Further intervention study is needed to reduce the risk of postoperative delirium for these patients. |
| 關聯: | International Journal of Geriatric Psychiatry, v.34, n.6, pp.881-888 |
| 顯示於類別: | [藥學系(所)] 期刊論文
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