老年髋部骨折术后亚谵妄患病率及影响因素分析

Analysis of the Incidence Rate and Influencing Factors of Subsyndromal Delirium after Hip Fracture Surgery in the Elderly

摘要: 目的：了解老年髋部骨折患者术后发生SSD的现状及危险因素。方法：选取2024年2月~6月在贵阳市某2所三级甲等医院骨外科行择期髋部骨折置换术/固定术的老年病人作为研究对象。术后前3天使用3分钟谵妄诊断量表(3D-CAM)对患者进行评估，采用自制的《危险因素调查表》、Barthel指数评定量表、焦虑自评量表(SAS)、Mini-Cog和衰弱量表(FRAIL)收集患者相关资料。结果：共纳入162例行髋部骨折手术的老年病人，其中86例发生亚谵妄综合征，发生率为53.8%。多因素分析显示，年龄、麻醉时间 ≥ 2 h和术前高血压是老年髋部骨折患者术后发生SSD的独立危险因素(P < 0.05)。结论：术前高血压、麻醉时间 ≥ 2 h和年龄是老年髋部骨折患者术后发生SSD的独立危险因素，医护人员应特别关注这些因素，并制定相应的干预措施。

Abstract: Objective: To investigate the current status and risk factors of SSD (Subsyndromal Delirium) occurrence after surgery in elderly patients with hip fractures. Methods: Elderly patients who underwent elective hip fracture replacement or fixation surgery in the orthopedic departments of two level 3A hospitals in Guiyang from February to June 2024 were selected as the study subjects. Patients were assessed on the first three days postoperatively using the 3-Minute Diagnostic Interview for CAM-defined Delirium (3D-CAM). Relevant patient data were collected using a self-designed Risk Factors Questionnaire, the Barthel Index Rating Scale, the Self-Rating Anxiety Scale (SAS), the Mini-Cog, and the Frail Scale (FRAIL). Results: A total of 162 elderly patients who underwent hip fracture surgery were included in the study, among whom 86 developed Subsyndromal Delirium (SSD), with an incidence rate of 53.8%. Multivariate analysis showed that age, anesthesia duration ≥ 2 hours, and preoperative hypertension were independent risk factors for the occurrence of SSD after hip fracture surgery in elderly patients (P < 0.05). Conclusion: Preoperative hypertension, anesthesia duration ≥ 2 hours, and age are independent risk factors for the occurrence of SSD after hip fracture surgery in elderly patients. Healthcare providers should pay special attention to these factors and develop appropriate intervention measures.