METHODS: A prospective cohort study.
METHODS: Operating room.
METHODS: Patients were adults scheduled for colorectal cancer surgery in 2023.
METHODS: The exposure factor was hyperlipidemia, and the patients were divided into hyperlipidemia group and non-hyperlipidemia group.
METHODS: POD occurrence within three days post-surgery was assessed using the 3-Minute Diagnostic Interview for Confusion Assessment Method. Over one year, these patients were monitored through telephone to evaluate their survival and cognitive function. Logistic regression analysis was performed to evaluate the risk factors for POD development in patients with hyperlipidemia and to construct a clinical prediction model.
RESULTS: This study included 555 patients. POD incidence was 21.6% in the hyperlipidemia group and 12.7% in the non-hyperlipidemia group. One year following surgery, patients with hyperlipidemia and POD exhibited significantly higher rates of mortality and cognitive decline than did those without POD (p < 0.001). A multifactorial logistic clinical prediction model was constructed from seven independent risk factors for POD development in patients with hyperlipidemia, including education, preoperative total cholesterol (TC), preoperative triglyceride (TG), diet, history of hypertension, Sedation-Agitation Scale, and postoperative trimethylamine N-oxide expression level, and it had the highest predictive value for POD development in patients with hyperlipidemia.
CONCLUSIONS: Compared with those without hyperlipidemia, patients with hyperlipidemia had higher POD incidence. Elevated serum TC and TG levels are independent risk factors for POD in patients with hyperlipidemia. The study\'s findings could help develop strategies for improving POD and hyperlipidemia treatment.
方法:前瞻性队列研究。
方法:手术室。
方法:患者为2023年计划接受结直肠癌手术的成年人。
方法:暴露因素为高脂血症,将患者分为高脂血症组和非高脂血症组。
方法:使用3分钟诊断性访谈进行混淆评估方法评估术后3天内的POD发生率。一年多,通过电话对这些患者进行监测,以评估他们的生存和认知功能.采用Logistic回归分析评估高脂血症患者POD发生的危险因素,构建临床预测模型。
结果:本研究纳入555名患者。高脂血症组POD发生率为21.6%,非高脂血症组为12.7%。手术一年后,有高脂血症和POD患者的死亡率和认知功能下降率显著高于无POD患者(p<0.001).从高脂血症患者POD发展的7个独立危险因素构建多因素Logistic临床预测模型,包括教育,术前总胆固醇(TC),术前甘油三酯(TG),饮食,高血压病史,镇静-搅动秤,和术后三甲胺N-氧化物表达水平,对高脂血症患者POD发生的预测价值最高。
结论:与无高脂血症者相比,高脂血症患者POD发生率较高。血清TC和TG水平升高是高脂血症患者POD的独立危险因素。该研究的发现有助于制定改善POD和高脂血症治疗的策略。