修正衰弱指数联合C-反应蛋白/白蛋白比值对老年椎管内麻醉患者术后谵妄的预测价值  

Predictive value of modified frailties index combined with C-reactive protein/albumin ratio for postoperative delirium in elderly patients with intraspinal anesthesia

作　　者：尹一 潘欢欢 雷振营 YIN Yi;PAN Huanhuan;LEI Zhenying(Department of Anesthesiology,Kaifeng Third People's Hospital(The First People's Hospital of Kaifeng Xiangfu District),Kaifeng 475100,China)

机构地区：[1]开封市第三人民医院(开封市祥符区第一人民医院)麻醉科,475100

出　　处：《中国老年保健医学》2025年第1期97-100,共4页Chinese Journal of Geriatric Care

摘　　要：目的分析术前修正衰弱指数(mFI)联合C-反应蛋白/白蛋白比值(CAR)对老年椎管内麻醉患者术后谵妄(POD)的预测价值。方法选择本院2022年1月至2024年6月择期于椎管内麻醉下行膝(髋)关节置换术的老年患者115例。根据是否发生POD将患者分为POD组(n=20)及非POD组(n=95),检测并比较两组患者术前mFI和CAR水平;采用多因素Logistic回归分析POD的影响因素,受试者工作特征(ROC)曲线评价术前mFI和CAR对POD的预测价值。结果POD组术前mFI和CAR水平明显高于非POD组(P<0.05)。多因素Logistic回归分析显示,术前mFI、CAR及年龄、ASA分级、术前MMSE评分、手术时间、术后住院时间是老年椎管内麻醉患者发生POD的独立影响因素(P<0.05)。ROC曲线结果显示,联合检测mFI和CAR预测老年椎管内麻醉患者发生POD的曲线下面积为0.727,高于单独预测的0.677和0.690。结论术前mFI和CAR是老年椎管内麻醉患者发生POD的独立影响因素,联合检测有助于评估POD的发生风险。Objective To analyze the predictive value of preoperative modified frailty index(mFI)combined with C-reactive protein/albumin ratio(CAR)for postoperative delirium(POD)in elderly patients undergoing spinal anesthesia.Methods 115 elderly patients who underwent knee/hip replacement surgery under spinal anesthesia at our hospital were selected.Patients were divided into the POD group(n=20)and the non-POD group(n=95)based on whether POD occurred,and their preoperative mFI and CAR levels were detected and compared between the two groups;Using multiple logistic regression analysis to identify the influencing factors of POD,the receiver operating characteristic(ROC)curve was used to evaluate the predictive value of preoperative mFI and CAR for POD.Results The preoperative mFI and CAR levels in the POD group were significantly higher than those in the non-POD group(P<0.05).Multivariate logistic regression analysis showed that preoperative mFI,CAR,age,ASA grading,preoperative MMSE score,operation time,and postoperative hospital stay were independent influencing factors for POD in elderly patients undergoing spinal anesthesia(P<0.05).The ROC curve results showed that the combined detection of mFI and CAR predicted an area under the curve of 0.727 for POD in elderly spinal anesthesia patients,which was higher than the separately predicted values of 0.677 and 0.690.Conclusion Preoperative mFI and CAR are independent influencing factors for the occurrence of POD in elderly patients undergoing spinal anesthesia,and combined detection can help evaluate the risk of POD occurrence.

关 键 词：修正衰弱指数 C-反应蛋白/白蛋白比值 椎管内麻醉 术后谵妄 

分 类 号：R614[医药卫生—麻醉学]