术中外科Apgar评分预测胰十二指肠切除术患者术后谵妄的价值

Value of intraoperative Surgical Apgar Score in predicting postoperative delirium in patients undergoing pancreaticoduodenectomy

收集本院2013年1月至2016年12月行胰十二指肠切除术的壶腹部恶性肿瘤患者的具有完整记录的病历资料,共纳入144例患者。根据术中最低MAP、最低HR和失血量计算外科Apgar评分(SAS)。根据术后7d内是否发生谵妄分为谵妄组和非谵妄组。绘制SAS判断术后谵妄的受试者工作特征曲线,计算曲线下面积、最佳临界值、灵敏度和特异度。有36例患者发生了术后谵妄,发生率为25.0%。SAS预测术后谵妄的曲线下面积为O.86,95%可信区间为0.79~0.91,临界值为6分,灵敏度为86%,特异度为83%。综上所述,术中SAS可预测胰十二指肠切除术患者术后谵妄的发生。

Clinical data of patients underwent pancreaticoduodenectomy due to malignant ampullary tumors from January 2013and December 2016in our hospital with full access to medical records were collected,and 144patients were enrolled in total.Surgical Apgar Score (SAS)was calculated based on the intraoperative lowest mean arterial pressure,lowest heart rate and blood loss.The patients were divided into 2groups depending on whether postoperative delirium developed or not within 7days after surgery.The receiver operating characteristic curve of SAS in predicting postoperative delirium was drawn.The area under the curve,optimal cut-off value and sensitivity and specificity were calculated.Thirty-six patients developed postoperative delirium,and the incidence was 25.0%.The area under the curve of SAS in predicting postoperative delirium was 0.86(95%confidence interval 0.79-0.91).The optimal cut-off value was 6 with a sensitivity of 86%and a specificity of 83%.In conclusion,intraoperative SAS can predict the development of postoperative delirium in patients undergoing pancreaticoduodenectomy.