营养相关指标预测老年患者腹部手术术后谵妄发生风险的价值

Value of nutrition-related indicators in predicting the risk of delirium in elderlypatients after abdominal surgery

目的探讨营养相关指标预测老年患者腹部手术术后谵妄发生风险的价值。方法选取2019月1月至2022年6月杭州市西溪医院收治的450例老年腹部手术术后患者为研究对象,测量所有患者营养相关指标,记录所有患者出院前谵妄发生情况,并根据患者术后谵妄发生情况分为发生组(n=58)和未发生组(n=392)。采用Logistic回归分析营养相关指标与老年患者腹部手术术后谵妄发生风险的相关性,采用受试者操作特征曲线分析营养相关指标预测老年患者腹部手术术后谵妄发生风险的效能。结果多因素Logistic回归分析显示高龄、高控制营养状况(controlling nutritional status,CONUT)评分是老年患者腹部手术术后谵妄发生的危险因素(P<0.05),高总胆固醇、高低密度脂蛋白胆固醇、高老年营养风险指数(geriatric nutritional risk index,GNRI)评分、高预后营养指数(prognostic nutritional index,PNI)评分是老年患者腹部手术术后谵妄发生的保护因素(P<0.05)。联合模型预测老年患者腹部手术术后谵妄发生的曲线下面积(area under curve,AUC)为0.809,且与GNRI评分-年龄、PNI评分-年龄、CONUT评分-年龄的AUC比较,差异均无统计学意义(P<0.05)。结论营养相关指标预测老年患者腹部手术术后谵妄发生具有较高效能。

Objective To explore the value of nutrition-related indicators in predicting the risk of delirium in elderly patients after abdominal surgery.Methods A total of 450 elderly postoperative abdominal surgery patients admitted to Hangzhou Xixi Hospital from January 2019 to June 2022 were selected for the study.All patients’nutrition-related indicators were measured and the occurrence of delirium before discharge was recorded for all patients,and the patients were divided into the occurrence group(n=58)and the non-occurrence group(n=392)according to the occurrence of postoperative delirium.Logistic regression was used to analyze the correlation between nutrition-related indicators and the risk of postoperative delirium in elderly abdominal surgery,and subject operating characteristic curves were used to analyze the efficacy of nutrition-related indicators in predicting the risk of postoperative delirium in elderly abdominal surgery.Results Multivariate Logistic regression analysis showed that advanced age and high controlling nutritional status(CONUT)score were the risk factors for delirium in elderly after abdominal surgery patients(P<0.05).Higher total cholesterol and low density lipoprotein cholesterol,higher geriatric nutritional risk index(GNRI)score,and higher prognostic nutritional index(PNI)score were protective factors for the occurrence of delirium in elderly after abdominal surgery patients(P<0.05).The area under curve(AUC)of the combined prediction model for delirium in elderly patients after abdominal surgery was 0.809,and there was no significant difference compared with the AUC of GNRI score-age,PNI score-age and CONUT score-age(P<0.05).Conclusion Nutrition-related indicators have high efficacy in predicting postoperative delirium in elderly after abdominal surgery patients.