老年髋部骨折病人术后认知功能与术中组织氧饱和度的关系

doi:10.3969/j.issn.1003-9198.2024.07.019

Abstract

Abstract: Objective To analyze the correlation between intraoperative tissue oxygen saturation and postoperative cognitive dysfunction(POCD) in the elderly patients with hip fracture. Methods A total of 215 elderly patients with hip fracture treated in our hospital from January 2020 to June 2022 were selected and divided into POCD group(n=42) and non-POCD group(n=173) according to Z score method determined by the International Study of Postoperative Cognitive Dysfunction (ISPOCD). The levels of cerebral tissue oxygen saturation(SctO₂) and lower limb muscle tissue oxygen saturation(SmtO₂) were observed and compared between the two groups. Logistic regression model was used to analyze the risk factors of POCD in the elderly patients with hip fracture. Receiver operating characteristic(ROC) curve was drawn to analyze the predictive value of SctO₂ for POCD in the elderly patients with hip fracture. Results The age, proportion of the patients with diabetes, intraoperative blood loss, anesthesia time, operation time, postoperative pain score and high sensitivity C reactive protein(hs-CRP) level were significantly higher, while the level of SctO₂ and the years of education were significantly lower in POCD group than those in non-POCD group(P<0.05). Logistic regression analysis showed that aged ≥80 years old, complicated with diabetes mellitus, high level of intraoperative blood loss and low level of SctO₂ were the risk factors for POCD(P<0.05). According to ROC curve analysis, SctO₂(68% as the optimal cut-off point) showed predictive value for POCD in the elderly patients with hip fracture, with the sensitivity, specificity and AUC of 90.70%, 90.17% and 0.809(95%CI: 0.742-0.875), respectively. Conclusions Low SctO₂, aged ≥80 years old, complicated with diabetes and high level of intraoperative blood loss are the risk factors for POCD in the elderly patients with hip fracture. SctO₂ has a good predictive value for POCD in the elderly patients with hip fracture.

Key words: hip fracture, aged, postoperative cognitive dysfunction, cerebral tissue oxygen saturation

CLC Number:

R 683.3

GONG Jian, LUO Cheng, SONG Chen, ZHAO Xiaoyong, FENG Zhijie. Relationship between postoperative cognitive dysfunction and intraoperative tissue oxygen saturation in elderly patients with hip fracture[J]. Practical Geriatrics, 2024, 38(7): 727-731.

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Relationship between postoperative cognitive dysfunction and intraoperative tissue oxygen saturation in elderly patients with hip fracture

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