UNASSIGNED: The present study is a secondary analysis of a retrospective cohort study conducted at the University of Washington Medical Center from April 2007 to September 2013. Patients with PAH who underwent non-cardiac, non-obstetric surgery were enrolled in the original research. We further excluded stroke, sepsis, and craniotomy patients from interfering with POD evaluation. The univariate regression analysis and multivariate-adjusted model were used to explore the influence of preoperative ACEIs/ARBs use on the occurrence of POD.
UNASSIGNED: A total of 539 patients were included in this study. The incidence of POD in these patients was 3.0%. Following the adjustment of potential confounders (age, BMI, smoking status, pulmonary arterial systolic pressure, length of surgery, vascular surgery, asthma, obstructive sleep apnea, renal failure, atrial fibrillation, coronary artery disease, hydrochlorothiazide, alpha-blocker, calcium channel blocker, antiplatelet, steroids, statin, isoflurane), a negative relationship was found between preoperative use of ACEIs/ARBs and occurrence of POD (OR = 0.15, 95%CI: 0.03 to 0.80, P = 0.0266).
UNASSIGNED: Preoperative use of ACEIs/ARBs in patients with PAH reduces the risk of POD. ACEIs/ARBs may be more recommended for patients with PAH in the future.
UNASSIGNED:本研究是对2007年4月至2013年9月在华盛顿大学医学中心进行的回顾性队列研究的二次分析。PAH患者接受非心脏,非产科手术纳入原研究.我们进一步排除了中风,脓毒症,和开颅手术患者干扰POD评估。采用单因素回归分析和多因素校正模型探讨术前使用ACEI/ARBs对POD发生的影响。
未经批准:本研究共纳入539例患者。这些患者的POD发生率为3.0%。在调整潜在的混杂因素(年龄,BMI,吸烟状况,肺动脉收缩压,手术长度,血管手术,哮喘,阻塞性睡眠呼吸暂停,肾功能衰竭,心房颤动,冠状动脉疾病,氢氯噻嗪,α-阻断剂,钙通道阻滞剂,抗血小板,类固醇,他汀类药物异氟烷),术前使用ACEI/ARBs与POD的发生呈负相关(OR=0.15,95CI:0.03~0.80,P=0.0266).
UNASSIGNED:PAH患者术前使用ACEI/ARBs可降低POD的风险。ACEI/ARBs在未来可能更多推荐用于PAH患者。